Healthcare Provider Details

I. General information

NPI: 1013785179
Provider Name (Legal Business Name): DLP TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2023
Last Update Date: 12/18/2023
Certification Date: 12/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11963 LAKE CIRCLE DR
SPRINGDALE OH
45246-1524
US

IV. Provider business mailing address

11963 LAKE CIRCLE DR
SPRINGDALE OH
45246-1524
US

V. Phone/Fax

Practice location:
  • Phone: 513-304-9924
  • Fax:
Mailing address:
  • Phone: 513-304-4992
  • 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: CAMERON D MUNDON
Title or Position: PRESIDENT
Credential:
Phone: 513-304-9924