Provider Demographics
NPI:1487286068
Name:PRO MEDICAL TRANSPORT LLC
Entity type:Organization
Organization Name:PRO MEDICAL TRANSPORT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-379-2442
Mailing Address - Street 1:862 BAILEY RD
Mailing Address - Street 2:
Mailing Address - City:YOUNG HARRIS
Mailing Address - State:GA
Mailing Address - Zip Code:30582-3167
Mailing Address - Country:US
Mailing Address - Phone:706-379-2442
Mailing Address - Fax:706-379-2442
Practice Address - Street 1:16 WAYNE BROOKS LN STE D
Practice Address - Street 2:
Practice Address - City:HAYESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28904-9602
Practice Address - Country:US
Practice Address - Phone:706-379-2442
Practice Address - Fax:706-379-2442
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRO MEDICAL TRANSPORT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-11
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport