1235472044 NPI number — ATL ELDERLY TRANSPORTATION LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235472044 NPI number — ATL ELDERLY TRANSPORTATION LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ATL ELDERLY TRANSPORTATION LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235472044
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/29/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 143546
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAYETTEVILLE
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30214-6533
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
877-528-6855
Provider Business Mailing Address Fax Number:
877-414-3647

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8140 WEBB ROAD
Provider Second Line Business Practice Location Address:
504
Provider Business Practice Location Address City Name:
RIVERDALE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30274-6533
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-528-6855
Provider Business Practice Location Address Fax Number:
877-414-3647
Provider Enumeration Date:
03/29/2013

Additional Information

Authorized Official

Authorized Official Last Name:
ARKOMAH
Authorized Official First Name:
ERIC
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
678-510-9827

Provider Taxonomy Codes

  • Taxonomy code: 343900000X , with the licence number:  056358716 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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