Provider Demographics
NPI:1215795547
Name:D&R INNOVATIVE SOLUTIONS
Entity type:Organization
Organization Name:D&R INNOVATIVE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DOMAIN
Authorized Official - Middle Name:OMEILIO
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-894-4114
Mailing Address - Street 1:6625 ARGYLE FOREST BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-6126
Mailing Address - Country:US
Mailing Address - Phone:904-894-4114
Mailing Address - Fax:
Practice Address - Street 1:6625 ARGYLE FOREST BLVD STE 4
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-6126
Practice Address - Country:US
Practice Address - Phone:904-894-4114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No253Z00000XAgenciesIn Home Supportive Care
No342000000XTransportation ServicesTransportation Network Company
No347C00000XTransportation ServicesPrivate Vehicle