Peach Medtro

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

PEACH MEDTRO

Practice address

1911 Grayson Hwy Ste 8-372
Grayson, GA 30017-1245

Phone

(229) 757-3224

NPI assigned

Jun 4, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cordrell Webb

Title

Member

Phone

(770) 369-1680

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1386485472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 GRAYSON HWY STE 8-372",
            "city": "GRAYSON",
            "state": "GA",
            "postal_code": "300171245",
            "telephone_number": "229-757-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 GRAYSON HWY STE 8-372",
            "city": "GRAYSON",
            "state": "GA",
            "postal_code": "300171245",
            "telephone_number": "229-757-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACH MEDTRO",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "WEBB",
        "authorized_official_first_name": "CORDRELL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "770-369-1680"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristi Pankhania, PHARMD
• Areeba Aleem Paracha
• Passion 4 Kids, LLC
• Sahil Patel, DMD
• Veer Patel
• Laticia Peck, SLP
• Denise Perry, LPN
• Demetria L Phillips, M.ED., CCC-SLP
• Platinum Adult Daycare
• Asha Yamini Ponugoti, DDS

• Non-emergency Medical Transport (VAN) in Grayson, GA
• Providers in Grayson, GA by specialty
• Non-emergency Medical Transport (VAN) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.