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NPI 1174027163

NPI 1174027163 : NICE AND CLEAN MEDICAL SERVICES : LAKE CITY, FL

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General NPI Number Information
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    NPI Number           |    1174027163
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    Entity Type          |    Organization 
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    Legal Business Name  |    NICE AND CLEAN MEDICAL SERVICES 
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Dates
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    Enumeration Date     |    03/22/2018
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    Last Update Date     |    01/14/2026
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Provider Practice Location Address
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    Address Line         |    196 NW PROCTOR GLN 
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    City                 |    LAKE CITY
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    State                |    FL
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    Zip                  |    32055-7622
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    Country              |    US
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    Telephone            |    850-363-9306
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    Fax                  |    855-326-8575
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Provider Business Mailing Address
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    Address Line         |    196 NW PROCTOR GLN 
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    City                 |    LAKE CITY
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    State                |    FL
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    Zip                  |    32055-7622
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    Country              |    US
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    Telephone            |    850-363-9306
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    Fax                  |    855-326-8575
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Authorized Official
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    Title or Position    |    ADMIN
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    Name                 |     LATASHA T GRAHAM 
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    Credential           |    
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    Telephone            |    386-754-8889
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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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