Provider Demographics
NPI:1992525109
Name:UPLIFTING TRANSPORT LLC
Entity type:Organization
Organization Name:UPLIFTING TRANSPORT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ELIJAH
Authorized Official - Middle Name:G
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:469-834-3065
Mailing Address - Street 1:2335 CLARK TRL
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-3052
Mailing Address - Country:US
Mailing Address - Phone:469-834-3065
Mailing Address - Fax:
Practice Address - Street 1:2335 CLARK TRL
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-3052
Practice Address - Country:US
Practice Address - Phone:469-834-3065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-14
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)