Provider Demographics
NPI:1093599771
Name:BLESSING 2 TRANSPORT LLC
Entity Type:Organization
Organization Name:BLESSING 2 TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHONDRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TARVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-776-0870
Mailing Address - Street 1:1012 LEVISTA DR
Mailing Address - Street 2:
Mailing Address - City:LOCUST GROVE
Mailing Address - State:GA
Mailing Address - Zip Code:30248-7076
Mailing Address - Country:US
Mailing Address - Phone:470-776-0870
Mailing Address - Fax:
Practice Address - Street 1:1012 LEVISTA DR
Practice Address - Street 2:
Practice Address - City:LOCUST GROVE
Practice Address - State:GA
Practice Address - Zip Code:30248-7076
Practice Address - Country:US
Practice Address - Phone:470-776-0870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)