Organization
MOUNTAIN MEDICAL TRANSPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZACHARY PHILYAW (CEO)
(706) 489-9199
Entity
Organization
Contact information
Practice address
5282 HIGHWAY 129 SOUTH, CLEVELAND, GA 30528-6761
(706) 489-9199
Mailing address
PO BOX 1792, CLEVELAND, GA 30528-0033
(706) 489-9199
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
154-04
GA
Other
Enumeration date
03/26/2013
Last updated
04/27/2015
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