Organization
LUKE MEDICAL TRANSPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VANCE ANDRE RAHAM MD (PARTNER)
(765) 265-5361
Entity
Organization
Contact information
Practice address
260 INTERNATIONAL PKWY STE 132, DALLAS, GA 30157-5706
(765) 265-5361
(678) 567-7922
Mailing address
750 MIMMS CT NW, MARIETTA, GA 30064-6227
(765) 265-5361
(678) 567-7922
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
—
—
3416L0300X
Land Ambulance
Primary
—
—
Other
Enumeration date
10/04/2019
Last updated
03/27/2020
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