Provider Demographics
NPI:1417746249
Name:KINDRED CARE MEDICAL TRANSPORT CORP
Entity type:Organization
Organization Name:KINDRED CARE MEDICAL TRANSPORT CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHIRMAUL
Authorized Official - Middle Name:ANDREW RICHARD
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-344-7696
Mailing Address - Street 1:3772 PLEASANTDALE RD STE 148
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30340-5678
Mailing Address - Country:US
Mailing Address - Phone:770-344-7696
Mailing Address - Fax:404-228-9277
Practice Address - Street 1:3772 PLEASANTDALE RD STE 148
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30340-5678
Practice Address - Country:US
Practice Address - Phone:770-344-7696
Practice Address - Fax:404-228-9277
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KINDRED CARE MEDICAL TRANSPORT CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport