Provider Demographics
NPI:1396106779
Name:GORE SAFE TRANSPORTATION LLC
Entity type:Organization
Organization Name:GORE SAFE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:NADA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEHAB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-508-0233
Mailing Address - Street 1:6110 POWERS AVE
Mailing Address - Street 2:SUITE 11
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-1206
Mailing Address - Country:US
Mailing Address - Phone:904-859-8859
Mailing Address - Fax:904-508-0236
Practice Address - Street 1:6110 POWERS AVE
Practice Address - Street 2:SUITE 11
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-1206
Practice Address - Country:US
Practice Address - Phone:904-859-8859
Practice Address - Fax:904-508-0236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-14
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL343900000X, 172A00000X
FLL-2465344600000X
347C00000X, 347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Multi-Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Multi-Specialty
No344600000XTransportation ServicesTaxi
No347C00000XTransportation ServicesPrivate Vehicle
No347E00000XTransportation ServicesTransportation Broker