Provider Demographics
NPI:1386235562
Name:QUALITY CARE PROFESSIONAL TRANSPORT LLC
Entity type:Organization
Organization Name:QUALITY CARE PROFESSIONAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-562-4156
Mailing Address - Street 1:3638 SNAPFINGER RD
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-3524
Mailing Address - Country:US
Mailing Address - Phone:678-562-4156
Mailing Address - Fax:877-624-9324
Practice Address - Street 1:3638 SNAPFINGER RD
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-3524
Practice Address - Country:US
Practice Address - Phone:678-562-4156
Practice Address - Fax:877-624-9324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-29
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)