Provider Demographics
NPI:1790595098
Name:NICKS NEMT
Entity type:Organization
Organization Name:NICKS NEMT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-247-6210
Mailing Address - Street 1:2358
Mailing Address - Street 2:
Mailing Address - City:SUNHILL HARRISON ROAD TENNILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31089
Mailing Address - Country:US
Mailing Address - Phone:478-247-6210
Mailing Address - Fax:
Practice Address - Street 1:2358 SUNHILL HARRISON ROAD
Practice Address - Street 2:
Practice Address - City:TENNILLE
Practice Address - State:GA
Practice Address - Zip Code:31089
Practice Address - Country:US
Practice Address - Phone:478-247-6210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)