GRACE CARE AMBULANCE TRANSPORT, LLC
NPI 1003321662
Ambulance - Land Transport in Lithonia, GA

Active since December 05, 2017CLIA 11D2274766 · Waiver
2372 S STONE MOUNTAIN RD., STE D, LITHONIA, GA 30058(404) 585-4857(404) 521-4686 Get Directions Write a Review

NPPES record last updated: May 28, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 28, 2025, Oct 7, 2019, Oct 3, 2019 and 1 more (4 updates tracked since 2017).

About Grace Care Ambulance Transport, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRACE CARE AMBULANCE TRANSPORT, LLC (NPI 1003321662) is a healthcare organization registered as a land transport in Lithonia, Georgia and active in the NPI registry since December 2017. The organization holds a CLIA Waiver certificate valid through January 9, 2027 and lists Carlton Theodore Anthony, Owner, as its authorized official.

NPPES Registry Identity

NPI1003321662
Entity TypeOrganization
Primary Taxonomy3416L0300X
Legal Business NameGRACE CARE AMBULANCE TRANSPORT, LLC
Location Address2372 S STONE MOUNTAIN RD., STE DLithonia, GA 30058
Mailing Address2372 S Stone Mountain Rd, Suite DLithonia, GA 30058 · (404) 585-4857 · Fax (404) 393-4041
Fax(404) 521-4686
Organization SubpartNo
Authorized OfficialCarlton Theodore AnthonyOwner · (404) 585-4857
Enumeration DateDecember 5, 2017
Last NPPES UpdateMay 28, 20254 updates tracked since enumeration
NPPES CertifiedMay 13, 2025
NPI 1003321662 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyAmbulance · Land TransportTransportation Services
Taxonomy Code3416L0300X
2372 S STONE MOUNTAIN RD., Lithonia, GA 30058

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2274766

Grace Care Ambulance Transport LLC · Lithonia, GA
Active · expires Jan 9, 2027
CLIA Number11D2274766
Laboratory TypeAmbulance
Certificate Effective DateJanuary 10, 2025
Certificate Expiration DateJanuary 9, 2027
Laboratory DirectorDr. Sulieman Wazeerud-Din
Laboratory Phone(404) 585-4857
Laboratory LocationGrace Care Ambulance Transport LLC2372 S Stone Mountain Lithonia Road, Lithonia, GA 30058
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Ground mileage, per statute mile A0425
Ground mileage per statute mile is a method of calculating the cost of transportation for medical services. It is used when a patient needs to be transported by ground ambulance. The cost is calculated per mile, from the pick-up location to the medical facility.
14,793 services57 patients
Ambulance service, basic life support, non-emergency transport, (bls) A0428
Basic Life Support (BLS) non-emergency ambulance service provides safe transportation for patients who don't need immediate medical attention. It includes monitoring vital signs, ensuring comfort, and administering basic care during transport.
1,971 services57 patients

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003321662, enumerated as an "organization" on December 05, 2017.

The provider is located at 2372 S STONE MOUNTAIN RD. STE D LITHONIA, GA 30058 and the phone number is (404) 585-4857.

Ambulance with taxonomy code 3416L0300X and a focus in Land Transport.