Provider Demographics
NPI:1912772591
Name:SOOL GROUP ENTERPRISE LLLP
Entity type:Organization
Organization Name:SOOL GROUP ENTERPRISE LLLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SAMIA
Authorized Official - Middle Name:OMER
Authorized Official - Last Name:KATUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-369-6582
Mailing Address - Street 1:3561 SANDY WOODS LN
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-4048
Mailing Address - Country:US
Mailing Address - Phone:404-369-6582
Mailing Address - Fax:
Practice Address - Street 1:3711 N DECATUR RD STE 107
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30032-1000
Practice Address - Country:US
Practice Address - Phone:404-369-6582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-24
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No3416L0300XTransportation ServicesAmbulanceLand Transport