Provider Demographics
NPI:1053739847
Name:TOTAL GLORY INC
Entity type:Organization
Organization Name:TOTAL GLORY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PASTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VERCILDA
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-629-4390
Mailing Address - Street 1:1572 HIGHWAY 85 N STE 313
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-7727
Mailing Address - Country:US
Mailing Address - Phone:770-629-4390
Mailing Address - Fax:770-629-4390
Practice Address - Street 1:1572 HIGHWAY 85 N STE 313
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7727
Practice Address - Country:US
Practice Address - Phone:770-629-4390
Practice Address - Fax:770-629-4390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-31
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA050842390347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker