Provider Demographics
NPI:1184077695
Name:JOHNSON & JOHNSON TRANSPORT LLC
Entity type:Organization
Organization Name:JOHNSON & JOHNSON TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-253-1159
Mailing Address - Street 1:P.O. BOX 251
Mailing Address - Street 2:
Mailing Address - City:UVALDA
Mailing Address - State:GA
Mailing Address - Zip Code:30473-3156
Mailing Address - Country:US
Mailing Address - Phone:912-594-1812
Mailing Address - Fax:912-594-1817
Practice Address - Street 1:210 S 1ST ST
Practice Address - Street 2:
Practice Address - City:UVALDA
Practice Address - State:GA
Practice Address - Zip Code:30473-3156
Practice Address - Country:US
Practice Address - Phone:912-594-1812
Practice Address - Fax:912-594-1817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-20
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2858343900000X
GAAMB20160113416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003182211AMedicaid