Provider Demographics
NPI:1023867181
Name:AT YOUR SERVICE MEDICAL TRANSPORT LLC
Entity type:Organization
Organization Name:AT YOUR SERVICE MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENIESE
Authorized Official - Middle Name:C
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-304-0139
Mailing Address - Street 1:519 FOREST PKWY STE 250
Mailing Address - Street 2:
Mailing Address - City:FOREST PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30297-6130
Mailing Address - Country:US
Mailing Address - Phone:770-304-0139
Mailing Address - Fax:
Practice Address - Street 1:519 FOREST PKWY STE 250
Practice Address - Street 2:
Practice Address - City:FOREST PARK
Practice Address - State:GA
Practice Address - Zip Code:30297-6130
Practice Address - Country:US
Practice Address - Phone:770-304-0139
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-13
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport