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General NPI Number Information
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NPI Number | 1467899310
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Entity Type | Organization
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Legal Business Name | COMPANION TRANSPORT, LLC
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Dates
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Enumeration Date | 06/02/2013
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Last Update Date | 06/02/2013
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Provider Practice Location Address
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Address Line | 3296 TRAVIATA PL
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City | SAN JOSE
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State | CA
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Zip | 95117-3028
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Country | US
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Telephone | 408-766-9002
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Fax | 408-516-9070
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Provider Business Mailing Address
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Address Line | 5205 PROSPECT RD #135-149
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City | SAN JOSE
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State | CA
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Zip | 95129-5000
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Country | US
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Telephone | 408-766-9002
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Fax | 408-516-9070
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Authorized Official
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Title or Position | CEO
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Name | DAREKE FLEMING
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Credential |
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Telephone | 408-766-9002
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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 |
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