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General NPI Number Information
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NPI Number | 1588838205
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Entity Type | Organization
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Legal Business Name | ACCESSIBLE MEDIVAN TRANSPROTATION
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Dates
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Enumeration Date | 04/14/2008
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 744 LESLIE LN
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City | SCHAUMBURG
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State | IL
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Zip | 60194-2612
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Country | US
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Telephone | 847-387-8067
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Fax | 847-387-8152
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Provider Business Mailing Address
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Address Line | 744 LESLIE LN
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City | SCHAUMBURG
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State | IL
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Zip | 60194-2612
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Country | US
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Telephone | 847-387-8067
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Fax | 847-387-8152
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. FERDINAND T DIZON
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Credential |
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Telephone | 847-387-8067
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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 | 6369 MC
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License Number State | IL
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