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General NPI Number Information
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NPI Number | 1376800599
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Entity Type | Organization
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Legal Business Name | GROVE TRANSPORTATION COMPANY OF MISSISSIPPI LLC
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Dates
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Enumeration Date | 04/12/2012
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Last Update Date | 04/12/2012
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Provider Practice Location Address
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Address Line | 1721 HARDY ST
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City | HATTIESBURG
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State | MS
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Zip | 39401-4911
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Country | US
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Telephone | 601-544-5403
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Fax | 601-510-1447
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Provider Business Mailing Address
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Address Line | 1721 HARDY ST
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City | HATTIESBURG
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State | MS
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Zip | 39401-4911
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Country | US
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Telephone | 601-544-5403
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. DANIEL REID
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Credential |
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Telephone | 415-860-7344
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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 | MS
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