Provider Demographics
NPI:1417576455
Name:DAVIS, PAQUETTE, AND MOLINEAUX HOLDINGS, LLC
Entity Type:Organization
Organization Name:DAVIS, PAQUETTE, AND MOLINEAUX HOLDINGS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:PAQUETTE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:678-510-3340
Mailing Address - Street 1:1395 S MARIETTA PKWY SE
Mailing Address - Street 2:STE 730 OFFICE A
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1395 S MARIETTA PKWY SE
Practice Address - Street 2:STE 730 OFFICE A
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067
Practice Address - Country:US
Practice Address - Phone:678-510-3340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)