Provider Demographics
NPI:1669019352
Name:POLARIS MOBILITY, INC.
Entity Type:Organization
Organization Name:POLARIS MOBILITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:GANTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-428-5266
Mailing Address - Street 1:2184 PARK AVE SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6946
Mailing Address - Country:US
Mailing Address - Phone:404-428-5266
Mailing Address - Fax:
Practice Address - Street 1:2184 PARK AVE SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6946
Practice Address - Country:US
Practice Address - Phone:404-428-5266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-02
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker