Provider Demographics
NPI:1275031668
Name:ADVANCED MEDICAL TRANSPORT LLC
Entity Type:Organization
Organization Name:ADVANCED MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:MCCLELLAN
Authorized Official - Last Name:TODD
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:404-246-1513
Mailing Address - Street 1:2484 TUCKERSTONE PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-3837
Mailing Address - Country:US
Mailing Address - Phone:404-901-8244
Mailing Address - Fax:
Practice Address - Street 1:3797 LONDON DR
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30032-2367
Practice Address - Country:US
Practice Address - Phone:404-246-1513
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-31
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport