Provider Demographics
NPI:1457772600
Name:REPUBLIK INC.
Entity type:Organization
Organization Name:REPUBLIK INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATION MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:MARTELL
Authorized Official - Last Name:TYLER
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:404-721-2324
Mailing Address - Street 1:695 PYLANT ST NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-3728
Mailing Address - Country:US
Mailing Address - Phone:404-721-2324
Mailing Address - Fax:404-393-4045
Practice Address - Street 1:695 PYLANT ST NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30306-3728
Practice Address - Country:US
Practice Address - Phone:404-721-2324
Practice Address - Fax:404-393-4045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)