Organization
PROVIDENCE TRANSPORTATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESMOND JAMAL GRIFFIN (OWNER)
(800) 560-0253
Entity
Organization
Contact information
Practice address
3800 CAMP CREEK PKWY SW BLDG 1400-116 SUITE 2287, ATLANTA, GA 30331-6045
(800) 560-0253
Mailing address
3800 CAMP CREEK PKWY SW BLDG 1400-116, ATLANTA, GA 30331-6045
(504) 418-1117
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982193165
—
GA
05
—
1982193165
—
LA
Enumeration date
05/03/2018
Last updated
09/28/2022
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