Provider Demographics
NPI:1144764655
Name:APPALACHIAN MEDICAL TRANSPORT LLC
Entity type:Organization
Organization Name:APPALACHIAN MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-802-4115
Mailing Address - Street 1:2420 EASTGATE PL # F-500
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-6199
Mailing Address - Country:US
Mailing Address - Phone:404-424-3268
Mailing Address - Fax:470-719-9220
Practice Address - Street 1:2420 EASTGATE PL # F-500
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6199
Practice Address - Country:US
Practice Address - Phone:404-424-3268
Practice Address - Fax:470-719-9220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-19
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport