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Organization

GLORY BROTHERS TRANSPORT LLLP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
COURTLAND DIXON (CEO)
(762) 258-1680
Entity
Organization

Contact information

Practice address
3470 UNIVERSITY AVE STE 4, COLUMBUS, GA 31907-7254
(800) 716-2613
Mailing address
3470 UNIVERSITY AVE STE 4, COLUMBUS, GA 31907-7254
(800) 716-2613

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NONE
NONE
Enumeration date
10/25/2022
Last updated
10/25/2022
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