Healthcare Provider Details
I. General information
NPI: 1972138402
Provider Name (Legal Business Name): DDS TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/05/2020
Last Update Date: 04/15/2020
Certification Date: 04/15/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
454 ANDERSON RD S STE 326
ROCK HILL SC
29730-3398
US
IV. Provider business mailing address
454 ANDERSON RD S STE 326
ROCK HILL SC
29730-3398
US
V. Phone/Fax
- Phone: 716-604-4687
- Fax:
- Phone: 716-604-4687
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DARLENE
STRICKLAND
Title or Position: OWNER
Credential:
Phone: 716-604-4687