Provider Demographics
NPI:1275374126
Name:FAVOR AID TRANS
Entity type:Organization
Organization Name:FAVOR AID TRANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIA
Authorized Official - Middle Name:BOWAY
Authorized Official - Last Name:ZOTAA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-343-7668
Mailing Address - Street 1:2030 BUFORD HWY PO BOX 58
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518
Mailing Address - Country:US
Mailing Address - Phone:678-663-7442
Mailing Address - Fax:
Practice Address - Street 1:8714 N SHORE DR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-4020
Practice Address - Country:US
Practice Address - Phone:678-663-7442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)