Provider Demographics
NPI:1154006930
Name:GEORGIA METRO TRANSPORT
Entity type:Organization
Organization Name:GEORGIA METRO TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICE AND CHAIRMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANTLEY
Authorized Official - Middle Name:ZAKK
Authorized Official - Last Name:SCUFFHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-914-1121
Mailing Address - Street 1:1441 CHESTNUT GAP RD
Mailing Address - Street 2:
Mailing Address - City:BLUE RIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30513-3966
Mailing Address - Country:US
Mailing Address - Phone:470-820-7700
Mailing Address - Fax:
Practice Address - Street 1:1441 CHESTNUT GAP RD
Practice Address - Street 2:
Practice Address - City:BLUE RIDGE
Practice Address - State:GA
Practice Address - Zip Code:30513-3966
Practice Address - Country:US
Practice Address - Phone:888-914-1121
Practice Address - Fax:888-914-1121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-19
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)