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General NPI Number Information
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NPI Number | 1245827708
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Entity Type | Organization
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Legal Business Name | ED WATERS TRANSPORT INC
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Dates
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Enumeration Date | 12/30/2020
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Last Update Date | 12/30/2020
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Provider Practice Location Address
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Address Line | 6938 DAYTON RD
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City | JACKSONVILLE
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State | FL
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Zip | 32210-2763
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Country | US
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Telephone | 904-210-0085
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Fax |
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Provider Business Mailing Address
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Address Line | 6938 DAYTON RD
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City | JACKSONVILLE
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State | FL
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Zip | 32210-2763
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Country | US
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Telephone | 904-210-0085
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | LINDA M WATERS
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Credential | OWNER
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Telephone | 904-718-8575
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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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