Provider Demographics
NPI:1285443259
Name:MANSFIELD NON-EMERGENCY TRANSPORTATION LLC
Entity type:Organization
Organization Name:MANSFIELD NON-EMERGENCY TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AUGUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NTIRANDEKURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-472-6676
Mailing Address - Street 1:5033 IVY WOOD LN APT 931
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76115-4056
Mailing Address - Country:US
Mailing Address - Phone:682-472-6676
Mailing Address - Fax:
Practice Address - Street 1:5033 IVY WOOD LN APT 931
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76115-4056
Practice Address - Country:US
Practice Address - Phone:682-472-6676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-04
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)