Provider Demographics
NPI:1508479502
Name:ALLIANCE TRANSPORTATION SERVICES
Entity Type:Organization
Organization Name:ALLIANCE TRANSPORTATION SERVICES
Other - Org Name:ALLIANCE MEDICAL TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DYSHANN
Authorized Official - Middle Name:
Authorized Official - Last Name:MACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-855-0863
Mailing Address - Street 1:1201 CLAIRMONT RD STE 100
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1258
Mailing Address - Country:US
Mailing Address - Phone:404-855-0863
Mailing Address - Fax:
Practice Address - Street 1:1201 CLAIRMONT RD STE 100
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1258
Practice Address - Country:US
Practice Address - Phone:404-855-0863
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-28
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport