Provider Demographics
NPI:1962513671
Name:NGMT,INC
Entity type:Organization
Organization Name:NGMT,INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SPENCER
Authorized Official - Middle Name:P
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-968-3057
Mailing Address - Street 1:PO BOX 2795
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30503-2795
Mailing Address - Country:US
Mailing Address - Phone:770-536-9625
Mailing Address - Fax:770-536-9628
Practice Address - Street 1:1742 CANDLER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30507-8427
Practice Address - Country:US
Practice Address - Phone:770-536-9625
Practice Address - Fax:770-536-9628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA069 -163416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA58962774AMedicaid