Provider Demographics
NPI:1639470289
Name:JOHNSON TRANSPORATION
Entity Type:Organization
Organization Name:JOHNSON TRANSPORATION
Other - Org Name:JOHNSON TRANSIT
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSIE
Authorized Official - Middle Name:HALL
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:706-990-8525
Mailing Address - Street 1:216 PINE LN
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30673-4036
Mailing Address - Country:US
Mailing Address - Phone:706-672-5117
Mailing Address - Fax:706-678-4867
Practice Address - Street 1:410 E BARNETT ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:GA
Practice Address - Zip Code:30673-1826
Practice Address - Country:US
Practice Address - Phone:706-672-5117
Practice Address - Fax:706-678-4867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-13
Last Update Date:2010-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA049044538343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)