Provider Demographics
NPI:1225870934
Name:ON DA GO TRANSPORT,LLC
Entity type:Organization
Organization Name:ON DA GO TRANSPORT,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:SHAWN
Authorized Official - Last Name:OXENDINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-610-9127
Mailing Address - Street 1:132 REMS DRIVE
Mailing Address - Street 2:
Mailing Address - City:MAXTON
Mailing Address - State:NC
Mailing Address - Zip Code:28364-2836
Mailing Address - Country:US
Mailing Address - Phone:910-610-9127
Mailing Address - Fax:
Practice Address - Street 1:132 REMS DRIVE
Practice Address - Street 2:
Practice Address - City:MAXTON
Practice Address - State:NC
Practice Address - Zip Code:28364-2836
Practice Address - Country:US
Practice Address - Phone:910-610-9127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-12
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)