Provider Demographics
NPI:1114242757
Name:CARING MAN IN A VAN
Entity Type:Organization
Organization Name:CARING MAN IN A VAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:CHAMBERLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-769-0075
Mailing Address - Street 1:1021 INDUSTRIAL BLVD.
Mailing Address - Street 2:SUITE B
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677
Mailing Address - Country:US
Mailing Address - Phone:706-769-0075
Mailing Address - Fax:800-849-1975
Practice Address - Street 1:1021 INDUSTRIAL BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-2761
Practice Address - Country:US
Practice Address - Phone:706-769-0075
Practice Address - Fax:800-849-1975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-06
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2010-275343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)