Provider Demographics
NPI:1295509156
Name:MERRILL NON EMERGENCY TRANSPORT LLC
Entity type:Organization
Organization Name:MERRILL NON EMERGENCY TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:MERRILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-402-7915
Mailing Address - Street 1:104 PLANTERS ROW
Mailing Address - Street 2:
Mailing Address - City:TIFTON
Mailing Address - State:GA
Mailing Address - Zip Code:31793-5570
Mailing Address - Country:US
Mailing Address - Phone:229-402-7915
Mailing Address - Fax:
Practice Address - Street 1:104 PLANTERS ROW
Practice Address - Street 2:
Practice Address - City:TIFTON
Practice Address - State:GA
Practice Address - Zip Code:31793-5570
Practice Address - Country:US
Practice Address - Phone:229-402-7915
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-10
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)