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General NPI Number Information
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NPI Number | 1376999599
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Entity Type | Organization
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Legal Business Name | HISGRACE TRANSPORTATION SERVICES
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Dates
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Enumeration Date | 05/06/2016
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Last Update Date | 05/06/2016
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Provider Practice Location Address
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Address Line | 3177 SARINA CIR
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City | EL PASO
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State | TX
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Zip | 79938-2742
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Country | US
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Telephone | 915-539-6133
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Fax |
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Provider Business Mailing Address
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Address Line | 3177 SARINA CIR
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City | EL PASO
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State | TX
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Zip | 79938-2742
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Country | US
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Telephone | 915-539-6133
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Fax |
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | MR. OLUSHOLA BOLARINWA
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Credential |
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Telephone | 915-539-6133
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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 | 40493904
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License Number State | TX
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