Provider Demographics
NPI:1659141257
Name:GOOD FAITH MEDICAL TRANSPORTATION SERVICES, LLC
Entity Type:Organization
Organization Name:GOOD FAITH MEDICAL TRANSPORTATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:QUINTUS
Authorized Official - Middle Name:
Authorized Official - Last Name:ENOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-777-3574
Mailing Address - Street 1:8728 ELMONT CIR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-1359
Mailing Address - Country:US
Mailing Address - Phone:678-777-3574
Mailing Address - Fax:
Practice Address - Street 1:8728 ELMONT CIR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-1359
Practice Address - Country:US
Practice Address - Phone:678-777-3574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)