Healthcare Provider Details

I. General information

NPI: 1821536400
Provider Name (Legal Business Name): IDROVE LOGISTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2017
Last Update Date: 02/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 TEAPOT DR
PFLUGERVILLE TX
78660-3025
US

IV. Provider business mailing address

1012 TEAPOT DR
PFLUGERVILLE TX
78660-3025
US

V. Phone/Fax

Practice location:
  • Phone: 512-621-6331
  • Fax:
Mailing address:
  • Phone: 512-621-6331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateTX

VIII. Authorized Official

Name: ABDUL D OSMAN
Title or Position: PRESIDENT
Credential:
Phone: 512-621-6331