Provider Demographics
NPI:1710487491
Name:JEDIDIAH'S INVESTMENT HOLDINGS, INC.
Entity Type:Organization
Organization Name:JEDIDIAH'S INVESTMENT HOLDINGS, INC.
Other - Org Name:JEDIDIAH TRANSPORTATION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LONNELL
Authorized Official - Middle Name:
Authorized Official - Last Name:GADSON PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-440-5505
Mailing Address - Street 1:4319 COVINGTON HWY STE 207
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-1206
Mailing Address - Country:US
Mailing Address - Phone:470-440-5505
Mailing Address - Fax:
Practice Address - Street 1:4319 COVINGTON HWY STE 207
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-1206
Practice Address - Country:US
Practice Address - Phone:470-440-5505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DBA JEDIDIAH TRANSPORTATION SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-19
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)