Provider Demographics
NPI:1881982809
Name:SENIORS ON THE MOVE EXPRESS LLC
Entity type:Organization
Organization Name:SENIORS ON THE MOVE EXPRESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-664-4431
Mailing Address - Street 1:107 MARDEN CT SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30082-4334
Mailing Address - Country:US
Mailing Address - Phone:404-664-4431
Mailing Address - Fax:
Practice Address - Street 1:107 MARDEN CT SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082-4334
Practice Address - Country:US
Practice Address - Phone:404-664-4431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SENIORS ON THE MOVE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-11
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA055869258343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)