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General NPI Number Information
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NPI Number | 1326442914
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Entity Type | Organization
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Legal Business Name | DIVINE CARE TRANSIT INC
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Dates
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Enumeration Date | 10/10/2014
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Last Update Date | 10/10/2014
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Provider Practice Location Address
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Address Line | 6117 N CLAREMONT AVE APT 3N
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City | CHICAGO
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State | IL
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Zip | 60659-5256
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Country | US
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Telephone | 773-592-9285
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Fax | 773-754-7381
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Provider Business Mailing Address
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Address Line | 6117 N CLAREMONT AVE APT 3N
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City | CHICAGO
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State | IL
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Zip | 60659-5256
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Country | US
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Telephone | 773-592-9285
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Fax | 773-754-7381
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Authorized Official
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Title or Position | MD/CEC
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Name | MRS. PAULINE OYIDIYA OHIRI
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Credential | MD
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Telephone | 773-592-9285
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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 | 68208726
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License Number State | IL
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