Healthcare Provider Details

I. General information

NPI: 1982118865
Provider Name (Legal Business Name): ROLASDOT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2017
Last Update Date: 11/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2429 S COLLINS ST
ARLINGTON TX
76014-1226
US

IV. Provider business mailing address

2429 S COLLINS ST
ARLINGTON TX
76014-1226
US

V. Phone/Fax

Practice location:
  • Phone: 817-372-0628
  • Fax:
Mailing address:
  • Phone: 817-372-0628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: OLAWALE IBRAHIM
Title or Position: MANAGER
Credential:
Phone: 817-372-0628