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General NPI Number Information
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NPI Number | 1063197002
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Entity Type | Organization
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Legal Business Name | EAGLE COMMUNITY TRANSPORT LLC
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Dates
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Enumeration Date | 06/19/2023
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 203 E DAMPIER ST
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City | INVERNESS
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State | FL
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Zip | 34450-4327
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Country | US
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Telephone | 386-283-3344
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Fax |
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Provider Business Mailing Address
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Address Line | 10590 SE 73RD AVE
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City | BELLEVIEW
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State | FL
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Zip | 34420-6385
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Country | US
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Telephone | 386-283-3344
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ERIN BRIE SNYDER
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Credential |
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Telephone | 386-283-3344
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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 |
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License Number State |
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