Provider Demographics
NPI: | 1699019190 |
---|---|
Name: | DUSHANAS TOUCH OF LOVE TRANSPORTATION L.L.C |
Entity type: | Organization |
Organization Name: | DUSHANAS TOUCH OF LOVE TRANSPORTATION L.L.C |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | SHUNDA |
Authorized Official - Middle Name: | INEZ |
Authorized Official - Last Name: | WHITFIELD |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 314-299-4768 |
Mailing Address - Street 1: | 3011 ORIENTAL DR |
Mailing Address - Street 2: | |
Mailing Address - City: | FLORISSANT |
Mailing Address - State: | MO |
Mailing Address - Zip Code: | 63031-1449 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 314-299-4768 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 3011 ORIENTAL DR |
Practice Address - Street 2: | |
Practice Address - City: | FLORISSANT |
Practice Address - State: | MO |
Practice Address - Zip Code: | 63031 |
Practice Address - Country: | US |
Practice Address - Phone: | 314-299-4768 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-11-21 |
Last Update Date: | 2012-11-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MO | LC1267768 | 343900000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) |