Provider Demographics
NPI:1962273532
Name:AZALEA MEDICAL TRANSPORT LLC
Entity type:Organization
Organization Name:AZALEA MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MCGANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-256-9732
Mailing Address - Street 1:PO BOX 18537
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15236-0537
Mailing Address - Country:US
Mailing Address - Phone:800-249-0544
Mailing Address - Fax:724-234-2796
Practice Address - Street 1:83 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-2146
Practice Address - Country:US
Practice Address - Phone:800-249-0544
Practice Address - Fax:724-234-2796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-12
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance