Organization
BLAKE'S MOBILE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE BLAKE (OWNER)
(910) 977-8699
Entity
Organization
Contact information
Practice address
821 KAITLYN DR, LOGANVILLE, GA 30052-6928
(910) 977-8699
(770) 710-0862
Mailing address
821 KAITLYN DR, LOGANVILLE, GA 30052-6928
(770) 710-0862
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
03/13/2014
Last updated
03/13/2014
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