Provider Demographics
NPI:1467858068
Name:ABBEY, AUGUSTA
Entity Type:Individual
Prefix:
First Name:AUGUSTA
Middle Name:
Last Name:ABBEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 MASTERS CLUB BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-6048
Mailing Address - Country:US
Mailing Address - Phone:404-918-1926
Mailing Address - Fax:866-468-4047
Practice Address - Street 1:101 BECKETT LN
Practice Address - Street 2:SUITE 505
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7155
Practice Address - Country:US
Practice Address - Phone:404-918-1926
Practice Address - Fax:866-468-4047
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-08
Last Update Date:2014-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No347E00000XTransportation ServicesTransportation Broker