Healthcare Provider Details
I. General information
NPI: 1497312532
Provider Name (Legal Business Name): HOPE ON WHEELS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/23/2019
Last Update Date: 08/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
882 12TH STREET 882 12TH STREET D5
HAMMONTON NJ
08037
US
IV. Provider business mailing address
PO BOX 1015
HAMMONTON NJ
08037
US
V. Phone/Fax
- Phone: 856-729-7519
- Fax:
- Phone: 856-729-7519
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 172A00000X |
| Taxonomy | Driver |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251V00000X |
| Taxonomy | Voluntary or Charitable Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 344600000X |
| Taxonomy | Taxi |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 347C00000X |
| Taxonomy | Private Vehicle |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 347E00000X |
| Taxonomy | Transportation Broker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EVA
MCCALLIN
Title or Position: CEO
Credential:
Phone: 856-729-7519