Organization
S AND W DIVERSIFIED TRANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILBERT TAFADZWA NYAMAYEDENGA (DIRECTOR)
(678) 308-0363
Entity
Organization
Contact information
Practice address
157 BURKE ST, STOCKBRIDGE, GA 30281-3433
(678) 993-7436
Mailing address
127 JACLAIRE LN, MCDONOUGH, GA 30252-3117
(678) 308-0363
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
09/17/2021
Last updated
09/17/2021
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