Mountain Medical Transport LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

154-04 Issued in GA

Legal business name

MOUNTAIN MEDICAL TRANSPORT LLC

Practice address

5282 Highway 129 South
Cleveland, GA 30528-6761

Phone

(706) 489-9199

NPI assigned

Mar 26, 2013

Last updated

Apr 27, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Zachary Philyaw

Title

Ceo

Phone

(706) 489-9199

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430092800000",
    "number": "1649512815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1792",
            "city": "CLEVELAND",
            "state": "GA",
            "postal_code": "305280033",
            "telephone_number": "706-489-9199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5282 HIGHWAY 129 SOUTH",
            "city": "CLEVELAND",
            "state": "GA",
            "postal_code": "305286761",
            "telephone_number": "706-489-9199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN MEDICAL TRANSPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-26",
        "last_updated": "2015-04-27",
        "status": "A",
        "authorized_official_last_name": "PHILYAW",
        "authorized_official_first_name": "ZACHARY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-489-9199"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "GA",
            "license": "154-04",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• O.W.a. Management Services, LLC (Cleveland Family Dental Center)

• Land Ambulance in Cleveland, GA
• Providers in Cleveland, GA by specialty
• Land Ambulance in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.