Provider Demographics
NPI:1598595266
Name:DARIDYM LOGISTICS CORPORATION
Entity type:Organization
Organization Name:DARIDYM LOGISTICS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:RICHARDSON
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-250-5120
Mailing Address - Street 1:205 MARTIN LUTHER KING JR RD
Mailing Address - Street 2:
Mailing Address - City:IRWINTON
Mailing Address - State:GA
Mailing Address - Zip Code:31042-2839
Mailing Address - Country:US
Mailing Address - Phone:478-290-5485
Mailing Address - Fax:
Practice Address - Street 1:205 MARTIN LUTHER KING JR RD
Practice Address - Street 2:
Practice Address - City:IRWINTON
Practice Address - State:GA
Practice Address - Zip Code:31042-2839
Practice Address - Country:US
Practice Address - Phone:478-290-5485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JIREH CORPORATION OF GEORGIA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)