Provider Demographics
NPI:1699586255
Name:CADRI TRANSPORT LLC
Entity type:Organization
Organization Name:CADRI TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANNUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-831-0122
Mailing Address - Street 1:1030 S HUTCHINS ST STE 4
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95240-5251
Mailing Address - Country:US
Mailing Address - Phone:209-831-0122
Mailing Address - Fax:
Practice Address - Street 1:2601 CARNATION WAY
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95242-4820
Practice Address - Country:US
Practice Address - Phone:209-831-0122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)