Organization
PRESTIGE HEALTHCARE SOUTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRENCE STEVENS (GENERAL MANAGER)
(678) 768-5614
Entity
Organization
Contact information
Practice address
5639 DEERFIELD CT, ATLANTA, GA 30349-3768
(678) 768-5614
Mailing address
PO BOX 1171, RED OAK, GA 30272-1171
(678) 768-5614
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
471467
GA
3416L0300X
Land Ambulance
471467
GA
343800000X
Secured Medical Transport (VAN)
471467
GA
343900000X
Non-emergency Medical Transport (VAN)
Primary
471467
GA
344600000X
Taxi
471467
GA
347B00000X
Bus
471467
GA
347C00000X
Private Vehicle
471467
GA
347E00000X
Transportation Broker
471467
GA
Other
Enumeration date
09/01/2013
Last updated
09/01/2013
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