Organization
A&E GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALVINN KINNEBREW (CEO)
(985) 607-4158
Entity
Organization
Contact information
Practice address
530 FORT ST NE, MARIETTA, GA 30060-1706
(985) 607-4158
Mailing address
530 FORT ST NE, MARIETTA, GA 30060-1706
(985) 607-4158
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
1300068788
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000200100
—
FL
05
—
0000500100
—
GA
Enumeration date
10/04/2013
Last updated
10/04/2013
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