Provider Demographics
NPI:1417547381
Name:4ANGELS NON-MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:4ANGELS NON-MEDICAL TRANSPORTATION
Other - Org Name:4ANGELS NON-EMERGENCY TRANSPORTATION
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-513-7312
Mailing Address - Street 1:2015 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-9120
Mailing Address - Country:US
Mailing Address - Phone:404-513-7312
Mailing Address - Fax:
Practice Address - Street 1:2015 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-9120
Practice Address - Country:US
Practice Address - Phone:404-421-6331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-24
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)