Provider Demographics
NPI:1659253144
Name:GOLDIESCARETRANSPORTATION
Entity type:Organization
Organization Name:GOLDIESCARETRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NON-MEDICAL TRANSOPRTATION
Authorized Official - Prefix:
Authorized Official - First Name:DEMETRIUS
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-694-3335
Mailing Address - Street 1:1307 BLAIRWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-6025
Mailing Address - Country:US
Mailing Address - Phone:937-694-3335
Mailing Address - Fax:
Practice Address - Street 1:1955 SHAFTESBURY RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-3817
Practice Address - Country:US
Practice Address - Phone:937-277-2740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOLDIESCARETRANSPORTATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)