Provider Demographics
NPI:1043784465
Name:FROM THE HEART MEDICAL TRANSPORTATION, LLC
Entity Type:Organization
Organization Name:FROM THE HEART MEDICAL TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GAINEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-250-5143
Mailing Address - Street 1:PO BOX 6771
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31208-6771
Mailing Address - Country:US
Mailing Address - Phone:478-250-5143
Mailing Address - Fax:
Practice Address - Street 1:698 MLK BLVD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-3285
Practice Address - Country:US
Practice Address - Phone:478-250-5143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport