Healthcare Provider Details

I. General information

NPI: 1447083647
Provider Name (Legal Business Name): BLK FLEET
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2024
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4130 LINDEN AVE STE 245
DAYTON OH
45432-3049
US

IV. Provider business mailing address

1928 COURTLAND AVE
KETTERING OH
45420-2147
US

V. Phone/Fax

Practice location:
  • Phone: 937-960-0152
  • Fax:
Mailing address:
  • Phone: 937-960-0152
  • 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

VIII. Authorized Official

Name: ANGEL DEANNA MURPHY
Title or Position: CEO
Credential:
Phone: 937-960-0152