Provider Demographics
NPI:1386345965
Name:ROAD WAGE LLC
Entity type:Organization
Organization Name:ROAD WAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MONA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MAHRM
Authorized Official - Phone:816-673-8441
Mailing Address - Street 1:24811 GOLDONI DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-7404
Mailing Address - Country:US
Mailing Address - Phone:816-673-8441
Mailing Address - Fax:
Practice Address - Street 1:24811 GOLDONI DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-7404
Practice Address - Country:US
Practice Address - Phone:816-673-8441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)