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TACTICAL MEDICAL TRANSPORT LLC
NPI 1205411006
Ambulance - Land Transport in Decatur, GA

Active since March 12, 2021CLIA 11D2276211 · Waiver
4284 MEMORIAL DR STE D, DECATUR, GA 30032(678) 832-8561 Get Directions Write a Review

NPPES record last updated: June 15, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 15, 2021, Mar 12, 2021 (2 updates tracked since 2021).

About Tactical Medical Transport Llc NPPES

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

TACTICAL MEDICAL TRANSPORT LLC (NPI 1205411006) is a healthcare organization registered as a land transport in Decatur, Georgia and active in the NPI registry since March 2021. The organization holds a CLIA Waiver certificate valid through February 5, 2027 and lists Shirmaul Wilson, Manager, as its authorized official.

NPPES Registry Identity

NPI1205411006
Entity TypeOrganization
Primary Taxonomy3416L0300X
Legal Business NameTACTICAL MEDICAL TRANSPORT LLC
Location Address4284 MEMORIAL DR STE DDecatur, GA 30032-1220
Mailing Address4284 Memorial Dr Ste DDecatur, GA 30032-1220
Phone(678) 832-8561
Organization SubpartNo
Authorized OfficialShirmaul WilsonManager · (678) 832-8561
Enumeration DateMarch 12, 2021
Last NPPES UpdateJune 15, 20212 updates tracked since enumeration
NPPES CertifiedJune 15, 2021
✔ NPI 1205411006 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAmbulance · Land TransportTransportation Services
Taxonomy Code3416L0300X
Also ListedNon-emergency Medical Transport (VAN)Taxonomy 343900000X
4284 MEMORIAL DR STE D, Decatur, GA 30032
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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 11D2276211

Tactical Medical Transport · Decatur, GA
Active · expires Feb 5, 2027
CLIA Number11D2276211
Laboratory TypeAmbulance
Certificate Effective DateFebruary 6, 2025
Certificate Expiration DateFebruary 5, 2027
Laboratory DirectorShirmaul Wilson
Laboratory Phone(470) 354-6970
Laboratory LocationTactical Medical Transport4284 Memorial Drive, Suite D, Decatur, GA 30032
CLIA data matches this NPI record on: Address Name
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 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.
23,806 services20 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.
3,394 services20 patients

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PHOENIX FAMILY RESOURCE CENTER
Substance Abuse Rehabilitation Facility
4284 MEMORIAL DR STE D
DECATUR, GA 30032
Dekalb County (678) 358-5099

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tactical Medical Transport LLC's NPI number?

The NPI number for Tactical Medical Transport LLC is 1205411006. It was assigned to this organization in the NPPES registry on March 12, 2021.

Where is Tactical Medical Transport LLC located?

Tactical Medical Transport LLC is located at 4284 Memorial Dr Ste D, Decatur, GA 30032. The listed phone number is (678) 832-8561.

What is Tactical Medical Transport LLC's specialty?

The primary specialty registered for this NPI is Ambulance, specializing in Land Transport, with taxonomy code 3416L0300X.

Does Tactical Medical Transport LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2276211) is associated with this NPI, valid through February 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Tactical Medical Transport LLC was last updated on June 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.