Provider Demographics
NPI:1235775818
Name:GA REGIONAL TRANSPORT COMPANY, LLC
Entity Type:Organization
Organization Name:GA REGIONAL TRANSPORT COMPANY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:SARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-237-6567
Mailing Address - Street 1:1850 REDMOND CIR NW STE 800
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-1463
Mailing Address - Country:US
Mailing Address - Phone:706-237-6567
Mailing Address - Fax:706-204-8762
Practice Address - Street 1:1850 REDMOND CIR NW STE 800
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-1463
Practice Address - Country:US
Practice Address - Phone:706-237-6567
Practice Address - Fax:706-204-8762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)