Healthcare Provider Details

I. General information

NPI: 1003742552
Provider Name (Legal Business Name): DIVINE DESTINATIONS TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 THE GRN STE 8
DOVER DE
19901-3618
US

IV. Provider business mailing address

8 THE GRN STE 8
DOVER DE
19901-3618
US

V. Phone/Fax

Practice location:
  • Phone: 509-768-2249
  • Fax:
Mailing address:
  • Phone: 509-768-2249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: STEVE BARZEGAR
Title or Position: OWNER
Credential:
Phone: 818-614-7767