Provider Demographics
NPI:1407174618
Name:GUIDING LIGHT TRANSPORTATION, LLC
Entity type:Organization
Organization Name:GUIDING LIGHT TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:S
Authorized Official - Last Name:BAIRD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-344-1199
Mailing Address - Street 1:3601 PRESERVE WOOD LN
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-5885
Mailing Address - Country:US
Mailing Address - Phone:678-344-1199
Mailing Address - Fax:678-807-5515
Practice Address - Street 1:3601 PRESERVE WOOD LN
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-5885
Practice Address - Country:US
Practice Address - Phone:678-344-1199
Practice Address - Fax:678-807-5515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2010000114343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)