Organization
BACK-N-4TH TRANSPORTATION SERVICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATANYA JEANNETTE JACKSON (OWNER/MANGER)
(404) 552-4667
Entity
Organization
Contact information
Practice address
9172 HOMEWOOD DR, RIVERDALE, GA 30274-4524
(404) 552-4667
Mailing address
9172 HOMEWOOD DR, RIVERDALE, GA 30274-4524
(404) 552-4667
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
07/13/2023
Last updated
07/13/2023
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