Provider Demographics
NPI:1285099838
Name:DARRIN EDELGLASS DBA QUALITY TRANSPORTATION
Entity type:Organization
Organization Name:DARRIN EDELGLASS DBA QUALITY TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DARRIN
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:EDELGLASS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-747-4386
Mailing Address - Street 1:PO BOX 273
Mailing Address - Street 2:
Mailing Address - City:WHITE SULPHUR SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12787-0273
Mailing Address - Country:US
Mailing Address - Phone:845-747-4386
Mailing Address - Fax:845-747-4568
Practice Address - Street 1:3319 STATE ROUTE 52
Practice Address - Street 2:
Practice Address - City:WHITE SULPHUR SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12787-0273
Practice Address - Country:US
Practice Address - Phone:845-747-4386
Practice Address - Fax:845-747-4568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-28
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY03964225344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03964225Medicaid