Provider Demographics
NPI:1326595695
Name:SUPPORT PLUS TRANSPORTATION SERVICE
Entity type:Organization
Organization Name:SUPPORT PLUS TRANSPORTATION SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BEATRICE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:918-851-9850
Mailing Address - Street 1:10605 E 33RD ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74146-1810
Mailing Address - Country:US
Mailing Address - Phone:918-851-9850
Mailing Address - Fax:918-610-5451
Practice Address - Street 1:10605 E 33RD ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-1810
Practice Address - Country:US
Practice Address - Phone:918-851-9850
Practice Address - Fax:918-610-5451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-05
Last Update Date:2016-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK080045917343900000X
OK080054917347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)