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General NPI Number Information
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NPI Number | 1013415173
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Entity Type | Organization
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Legal Business Name | MARY HUGHES TRANSPORT
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Dates
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Enumeration Date | 01/24/2018
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Last Update Date | 01/24/2018
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Provider Practice Location Address
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Address Line | 4375 SW COUNTY ROAD 152
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City | JASPER
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State | FL
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Zip | 32052-3773
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Country | US
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Telephone | 386-792-1597
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Fax |
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Provider Business Mailing Address
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Address Line | 4375 SW COUNTY ROAD 152
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City | JASPER
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State | FL
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Zip | 32052-3773
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Country | US
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Telephone | 386-792-1597
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Fax | 386-792-1853
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Authorized Official
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Title or Position | OWNER
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Name | MARY HUGHES
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Credential |
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Telephone | 386-792-1597
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | DKBN63
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License Number State | FL
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