Healthcare Provider Details

I. General information

NPI: 1306693502
Provider Name (Legal Business Name): HERCULES TRANSPORTATION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2024
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11001 DESERT SPARROW AVE
WEEKI WACHEE FL
34613-5379
US

IV. Provider business mailing address

PO BOX 6488
SPRING HILL FL
34611-6488
US

V. Phone/Fax

Practice location:
  • Phone: 516-810-7496
  • Fax:
Mailing address:
  • Phone: 516-810-7496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: HERCULES MACK JR.
Title or Position: MGR.
Credential:
Phone: 516-810-7496