Provider Demographics
NPI:1093580136
Name:INFINITY ASD SERVICES, LLC
Entity Type:Organization
Organization Name:INFINITY ASD SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:REGINALD
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-227-0689
Mailing Address - Street 1:1880 BRASELTON HWY STE 118
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-2877
Mailing Address - Country:US
Mailing Address - Phone:678-227-0689
Mailing Address - Fax:
Practice Address - Street 1:1880 BRASELTON HWY STE 118
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-2877
Practice Address - Country:US
Practice Address - Phone:678-227-0689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)