Healthcare Provider Details

I. General information

NPI: 1083996110
Provider Name (Legal Business Name): TRANSPO TO GO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2011
Last Update Date: 09/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 RIVERFRONT DR SUITE 2406
DETROIT MI
48226-4500
US

IV. Provider business mailing address

1010 E. 7 MILE ROAD
DETROIT MI
48203
US

V. Phone/Fax

Practice location:
  • Phone: 313-460-2920
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: KAREN CLARK
Title or Position: PRESIDENT
Credential:
Phone: 313-460-2920