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General NPI Number Information
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NPI Number | 1124720875
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Entity Type | Individual
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Provider Name | CASANDRIA SANDERS
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Gender | Female
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Dates
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Enumeration Date | 03/20/2023
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Last Update Date | 03/20/2023
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Provider Practice Location Address
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Address Line | 144 WOFFORD RD UNIT A
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City | TAYLORS
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State | SC
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Zip | 29687-6056
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Country | US
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Telephone | 864-501-2247
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Fax |
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Provider Business Mailing Address
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Address Line | 1748 RALEIGH TRL
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City | ROMEOVILLE
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State | IL
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Zip | 60446-5073
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Country | US
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Telephone | 770-866-2518
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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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