Provider Demographics
NPI:1326408378
Name:SR & L TRANSPORT SERVICES, LLC
Entity Type:Organization
Organization Name:SR & L TRANSPORT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MULDREW
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:678-324-7944
Mailing Address - Street 1:4841 BLACK BEAR TRAIL
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135
Mailing Address - Country:US
Mailing Address - Phone:678-324-7944
Mailing Address - Fax:770-702-5500
Practice Address - Street 1:4841 BLACK BEAR TRAIL
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135
Practice Address - Country:US
Practice Address - Phone:678-324-7944
Practice Address - Fax:770-702-5500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA13450396343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)