Provider Demographics
NPI:1568146868
Name:SADIE TRANSPORT SERVICES
Entity Type:Organization
Organization Name:SADIE TRANSPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREASE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BROOMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-548-7865
Mailing Address - Street 1:3939 LAVISTA RD SUITE E #395
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-4847
Mailing Address - Country:US
Mailing Address - Phone:678-548-7865
Mailing Address - Fax:
Practice Address - Street 1:2308 EAGLES NEST CIRCLE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035
Practice Address - Country:US
Practice Address - Phone:678-548-7865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-15
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)