Provider Demographics
NPI:1124720875
Name:SANDERS, CASANDRIA
Entity type:Individual
Prefix:
First Name:CASANDRIA
Middle Name:
Last Name:SANDERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1748 RALEIGH TRL
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-5073
Mailing Address - Country:US
Mailing Address - Phone:770-866-2518
Mailing Address - Fax:
Practice Address - Street 1:144 WOFFORD RD UNIT A
Practice Address - Street 2:
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687-6056
Practice Address - Country:US
Practice Address - Phone:864-501-2247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)