Provider Demographics
NPI:1922371640
Name:MOUNTAIN TRANSPORTATION;L.L.C.
Entity Type:Organization
Organization Name:MOUNTAIN TRANSPORTATION;L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MGR
Authorized Official - Prefix:MISS
Authorized Official - First Name:ESTELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HILFSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-851-9465
Mailing Address - Street 1:19 THE FOREST ROAD
Mailing Address - Street 2:
Mailing Address - City:BLUE RIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30513
Mailing Address - Country:US
Mailing Address - Phone:706-851-9465
Mailing Address - Fax:706-632-5377
Practice Address - Street 1:19 THE FOREST RD
Practice Address - Street 2:
Practice Address - City:BLUE RIDGE
Practice Address - State:GA
Practice Address - Zip Code:30513-9219
Practice Address - Country:US
Practice Address - Phone:706-851-9465
Practice Address - Fax:706-632-5377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-10
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA343900000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle