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General NPI Number Information
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NPI Number | 1336489947
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Entity Type | Organization
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Legal Business Name | EXECUTIVE CONCIERGE TRANSPORTATION LLC
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Dates
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Enumeration Date | 02/19/2013
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Last Update Date | 11/04/2013
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Provider Practice Location Address
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Address Line | 616 LEWIS ST
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City | BIRMINGHAM
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State | MI
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Zip | 48009-6525
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Country | US
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Telephone | 248-953-2475
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Fax |
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Provider Business Mailing Address
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Address Line | 616 LEWIS ST
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City | BIRMINGHAM
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State | MI
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Zip | 48009-6525
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Country | US
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Telephone | 248-953-2475
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ANTHONY SERENO
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Credential |
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Telephone | 248-953-2475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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