Provider Demographics
NPI:1861765745
Name:MEDIXX TRANSPORT, LLC
Entity type:Organization
Organization Name:MEDIXX TRANSPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-538-8505
Mailing Address - Street 1:PO BOX 1983
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:GA
Mailing Address - Zip Code:30475-1983
Mailing Address - Country:US
Mailing Address - Phone:912-538-8505
Mailing Address - Fax:912-538-8545
Practice Address - Street 1:5940 GA HIGHWAY 29
Practice Address - Street 2:
Practice Address - City:SOPERTON
Practice Address - State:GA
Practice Address - Zip Code:30457-5232
Practice Address - Country:US
Practice Address - Phone:912-538-8505
Practice Address - Fax:912-538-8545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-22
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA140-063416L0300X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport