Provider Demographics
NPI:1790234714
Name:SAWNEE MEDICAL SERVICES
Entity Type:Organization
Organization Name:SAWNEE MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:DONOVAN
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:PMDC
Authorized Official - Phone:770-543-9432
Mailing Address - Street 1:135 ENTERPRISE DR
Mailing Address - Street 2:SUITE H
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-1607
Mailing Address - Country:US
Mailing Address - Phone:678-807-7980
Mailing Address - Fax:678-807-2848
Practice Address - Street 1:135 ENTERPRISE DR
Practice Address - Street 2:SUITE H
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-1607
Practice Address - Country:US
Practice Address - Phone:678-807-7980
Practice Address - Fax:678-807-2848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-03
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAMB20160153416L0300X, 343800000X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)