Provider Demographics
NPI:1417608589
Name:JOYFUL TRANSIT NON-EMERGENCY MEDICAL/SENIOR TRANSPORTATION SERVICES
Entity Type:Organization
Organization Name:JOYFUL TRANSIT NON-EMERGENCY MEDICAL/SENIOR TRANSPORTATION SERVICES
Other - Org Name:JOYFUL TRANSIT NEMT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FELTON
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:678-557-5770
Mailing Address - Street 1:4190 MISTYMORN WAY
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-2591
Mailing Address - Country:US
Mailing Address - Phone:989-598-0813
Mailing Address - Fax:770-557-5770
Practice Address - Street 1:4190 MISTYMORN WAY
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-2591
Practice Address - Country:US
Practice Address - Phone:678-557-5770
Practice Address - Fax:770-800-8127
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FELTON LEWIS JACKSON III
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-11
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA372788907Medicaid