Provider Demographics
NPI:1528867033
Name:GOINS, VEDA LATRICE (OWNER)
Entity type:Individual
Prefix:
First Name:VEDA
Middle Name:LATRICE
Last Name:GOINS
Suffix:
Gender:F
Credentials:OWNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 FLAT SHOALS RD APT 1208
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30291-2401
Mailing Address - Country:US
Mailing Address - Phone:770-771-3588
Mailing Address - Fax:
Practice Address - Street 1:4827 OLD NATIONAL HWY STE 1055
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30337-6234
Practice Address - Country:US
Practice Address - Phone:770-771-3588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACKA8721347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle