Healthcare Provider Details

I. General information

NPI: 1780161521
Provider Name (Legal Business Name): DART, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2018
Last Update Date: 07/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 HUSS DR
CHICO CA
95928
US

IV. Provider business mailing address

PO BOX 24
CHICO CA
95927-0024
US

V. Phone/Fax

Practice location:
  • Phone: 916-990-1467
  • Fax:
Mailing address:
  • Phone: 916-990-1467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: BRENT RUSSELL MORGAN
Title or Position: OWNER
Credential:
Phone: 916-990-1467