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General NPI Number Information
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NPI Number | 1689857823
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Entity Type | Organization
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Legal Business Name | CHARISMA TRANSPORTATION SERVICE LLC
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Dates
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Enumeration Date | 12/11/2007
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Last Update Date | 12/11/2007
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Provider Practice Location Address
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Address Line | 18322 NADOL DR
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City | SOUTHFIELD
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State | MI
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Zip | 48075-5830
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Country | US
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Telephone | 248-552-0389
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Fax |
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Provider Business Mailing Address
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Address Line | 18322 NADOL DR
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City | SOUTHFIELD
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State | MI
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Zip | 48075-5830
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Country | US
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Telephone | 248-552-0389
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | SAMUEL THOMPSON
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Credential | REV.
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Telephone | 313-850-8534
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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 | L-1811 CERTIFICATE
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License Number State | MI
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