Healthcare Provider Details

I. General information

NPI: 1912754375
Provider Name (Legal Business Name): SAFE AND SECURE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2024
Last Update Date: 05/03/2024
Certification Date: 04/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

361 SOUTHWEST DR # 748
JONESBORO AR
72401-5854
US

IV. Provider business mailing address

361 SOUTHWEST DR # 748
JONESBORO AR
72401-5854
US

V. Phone/Fax

Practice location:
  • Phone: 817-217-8151
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: CARLY BOHANNON
Title or Position: CEO
Credential:
Phone: 817-217-8151