Provider Demographics
NPI:1508565946
Name:YOUR MEDICAL TRANSPORT LLC
Entity Type:Organization
Organization Name:YOUR MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WINSTON
Authorized Official - Suffix:
Authorized Official - Credentials:BLS AED
Authorized Official - Phone:470-586-4957
Mailing Address - Street 1:600 FITZGERALD PLACE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349
Mailing Address - Country:US
Mailing Address - Phone:470-586-4957
Mailing Address - Fax:
Practice Address - Street 1:600 FITZGERALD PL
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-1055
Practice Address - Country:US
Practice Address - Phone:470-586-4957
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-24
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle