Provider Demographics
NPI:1184479768
Name:REFRESHED EXPRESS TRANSPORT AND COURIER SERVICES
Entity type:Organization
Organization Name:REFRESHED EXPRESS TRANSPORT AND COURIER SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:OPAL
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-663-4367
Mailing Address - Street 1:1309 PONDEROSA DR APT A1
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31601-3478
Mailing Address - Country:US
Mailing Address - Phone:470-663-4367
Mailing Address - Fax:
Practice Address - Street 1:3863 HIGHWAY 138 SE UNIT 45
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-4143
Practice Address - Country:US
Practice Address - Phone:470-663-4367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No3416L0300XTransportation ServicesAmbulanceLand Transport