Provider Demographics
NPI:1609208263
Name:THRIVE MEDICAL TRANSPORT
Entity Type:Organization
Organization Name:THRIVE MEDICAL TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-I
Authorized Official - Phone:678-323-6775
Mailing Address - Street 1:2442 STONE MOUNTAIN LITHONIA RD
Mailing Address - Street 2:SUITE J
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-5247
Mailing Address - Country:US
Mailing Address - Phone:678-323-6775
Mailing Address - Fax:
Practice Address - Street 1:2442 STONE MOUNTAIN LITHONIA RD
Practice Address - Street 2:SUITE J
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-5247
Practice Address - Country:US
Practice Address - Phone:678-323-6775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA40656341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance