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General NPI Number Information
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NPI Number | 1124487582
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Entity Type | Organization
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Legal Business Name | SMART START TRANSPORTATION INC
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Dates
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Enumeration Date | 02/14/2016
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Last Update Date | 02/23/2016
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Provider Practice Location Address
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Address Line | 2711 E 93RD ST
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City | CHICAGO
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State | IL
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Zip | 60617-4110
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Country | US
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Telephone | 773-354-7296
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Fax | 872-666-5225
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Provider Business Mailing Address
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Address Line | 2711 E 93RD ST
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City | CHICAGO
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State | IL
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Zip | 60617-4110
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Country | US
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Telephone | 773-354-7296
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Fax | 872-666-5225
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MISS REDONIA LATREASE LAWSON
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Credential |
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Telephone | 773-354-7296
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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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