Healthcare Provider Details

I. General information

NPI: 1003378969
Provider Name (Legal Business Name): AND LEIGH TRANSPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2019
Last Update Date: 04/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

487 LISBON AVE
BUFFALO NY
14215-1211
US

IV. Provider business mailing address

487 LISBON AVE
BUFFALO NY
14215-1211
US

V. Phone/Fax

Practice location:
  • Phone: 716-406-8954
  • 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
# 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: TEONNA FLEMING
Title or Position: OWNER
Credential:
Phone: 716-406-8954