Provider Demographics
NPI:1588976302
Name:WITCONN ENTERPRISES LLC
Entity type:Organization
Organization Name:WITCONN ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:CONNERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-736-6115
Mailing Address - Street 1:15 MONROVIA ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-2110
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15 MONROVIA ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-2110
Practice Address - Country:US
Practice Address - Phone:413-736-6115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WITCONN ENTERPRISES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-09
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)