Provider Demographics
NPI:1063277390
Name:DOC PICKUP LLC
Entity type:Organization
Organization Name:DOC PICKUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRESNER
Authorized Official - Middle Name:
Authorized Official - Last Name:RANFORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-671-0803
Mailing Address - Street 1:87 GARDEN CITY AVE
Mailing Address - Street 2:
Mailing Address - City:WYANDANCH
Mailing Address - State:NY
Mailing Address - Zip Code:11798-2817
Mailing Address - Country:US
Mailing Address - Phone:631-671-0803
Mailing Address - Fax:
Practice Address - Street 1:87 GARDEN CITY AVE
Practice Address - Street 2:
Practice Address - City:WYANDANCH
Practice Address - State:NY
Practice Address - Zip Code:11798-2817
Practice Address - Country:US
Practice Address - Phone:631-671-0803
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle