Provider Demographics
NPI:1730593153
Name:LEWIS, ANTHONY SR
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:LEWIS
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 DUNMURRY PL
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31093-3514
Mailing Address - Country:US
Mailing Address - Phone:478-225-0638
Mailing Address - Fax:866-225-2261
Practice Address - Street 1:224 DUNMURRY PL
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-3514
Practice Address - Country:US
Practice Address - Phone:478-225-0638
Practice Address - Fax:866-225-2261
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)