Organization
MEDIVAN TRANSPORT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAULA D COPELAND (MANAGER)
(912) 526-0859
Entity
Organization
Contact information
Practice address
234 N VICTORY DR, LYONS, GA 30436-1036
(912) 526-0859
Mailing address
PO BOX 2, UVALDA, GA 30473-0002
(912) 526-0859
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
05/22/2012
Last updated
05/22/2012
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