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General NPI Number Information
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NPI Number | 1275856825
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Entity Type | Organization
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Legal Business Name | STRAIGHT FORWARD TRANSPORTATION, LLC
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Dates
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Enumeration Date | 03/10/2010
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Last Update Date | 03/10/2010
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Provider Practice Location Address
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Address Line | 22844 MELROSE AVE
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City | EASTPOINTE
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State | MI
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Zip | 48021-1776
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Country | US
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Telephone | 586-994-9273
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Fax | 586-872-2232
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Provider Business Mailing Address
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Address Line | 22844 MELROSE AVE
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City | EASTPOINTE
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State | MI
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Zip | 48021-1776
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Country | US
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Telephone | 586-994-9273
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Fax | 586-872-2232
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MR. KURK JOHNSON NANCE SR.
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Credential |
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Telephone | 586-994-9273
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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 | N520481428790
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License Number State | MI
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