Healthcare Provider Details

I. General information

NPI: 1780494260
Provider Name (Legal Business Name): CROWNFIT LOGISTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2025
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8439 NEWPORT MANOR TRCE
RICHMOND TX
77407-3966
US

IV. Provider business mailing address

8439 NEWPORT MANOR TRCE
RICHMOND TX
77407-3966
US

V. Phone/Fax

Practice location:
  • Phone: 346-219-4875
  • Fax:
Mailing address:
  • Phone: 346-219-4875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: ABIOLA ADEBOWALE
Title or Position: MANAGER
Credential:
Phone: 346-219-4875