Provider Demographics
NPI:1568764892
Name:A-TOWN TRANSPORT, LLC
Entity Type:Organization
Organization Name:A-TOWN TRANSPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:AMOS
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:404-729-8096
Mailing Address - Street 1:2618 MAX CLELAND BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-4495
Mailing Address - Country:US
Mailing Address - Phone:404-729-8096
Mailing Address - Fax:770-879-9722
Practice Address - Street 1:2618 MAX CLELAND BLVD STE A
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-4495
Practice Address - Country:US
Practice Address - Phone:404-729-8096
Practice Address - Fax:770-879-9722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-18
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)