Organization
SUPERIOR MEDICAL TRANSPORT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FOSTER JACOBS (PRESIDENT)
(678) 993-3824
Entity
Organization
Contact information
Practice address
1256 OAKBROOK DR STE C, NORCROSS, GA 30093-2247
(678) 866-1467
(678) 325-5601
Mailing address
PO BOX 2862, LILBURN, GA 30048-2862
(678) 993-3824
(678) 325-5601
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
AMB2017029
GA
343900000X
Non-emergency Medical Transport (VAN)
2016000074
GA
Other
Enumeration date
02/04/2016
Last updated
02/15/2018
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