Provider Demographics
NPI:1023361037
Name:GOOD SHEPHERD TRANSPORT INC
Entity Type:Organization
Organization Name:GOOD SHEPHERD TRANSPORT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-265-8403
Mailing Address - Street 1:4865 S YORK HWY
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38556-6568
Mailing Address - Country:US
Mailing Address - Phone:931-265-8403
Mailing Address - Fax:931-863-4989
Practice Address - Street 1:4865 S YORK HWY
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:TN
Practice Address - Zip Code:38556-6568
Practice Address - Country:US
Practice Address - Phone:931-265-8403
Practice Address - Fax:931-863-4989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)