Provider Demographics
NPI:1770262495
Name:CRUMS A-1 TRANSPORT LLC
Entity type:Organization
Organization Name:CRUMS A-1 TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CRUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-310-5475
Mailing Address - Street 1:4625 SMOKESTONE DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-4991
Mailing Address - Country:US
Mailing Address - Phone:770-310-5475
Mailing Address - Fax:
Practice Address - Street 1:8413 CHICAGO AVE,
Practice Address - Street 2:SUITE B
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-1114
Practice Address - Country:US
Practice Address - Phone:470-363-5324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)