Healthcare Provider Details

I. General information

NPI: 1376965921
Provider Name (Legal Business Name): ALLIED WHEELCHAIR VAN SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2014
Last Update Date: 01/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 LAFAYETTE RD UNIT 208
HAMPTON NH
03842-1295
US

IV. Provider business mailing address

PO BOX 851
EXETER NH
03833-0851
US

V. Phone/Fax

Practice location:
  • Phone: 603-498-7918
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: RICHARD ALAN DEARBORN
Title or Position: OWNER
Credential:
Phone: 603-498-7918