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General NPI Number Information
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NPI Number | 1700377801
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Entity Type | Organization
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Legal Business Name | A&S SMOOTHRIDE, LLC
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Dates
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Enumeration Date | 05/23/2018
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Last Update Date | 05/23/2018
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Provider Practice Location Address
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Address Line | 3001 S HARDIN BLVD STE 110-314
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City | MCKINNEY
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State | TX
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Zip | 75070-7736
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Country | US
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Telephone | 469-782-8220
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Fax |
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Provider Business Mailing Address
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Address Line | 3001 S HARDIN BLVD STE 110-314
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City | MCKINNEY
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State | TX
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Zip | 75070-7736
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Country | US
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Telephone | 469-782-8220
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SAMUEL S FASANYA
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Credential | BSC, MHA
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Telephone | 469-782-8220
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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 | 802715611
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License Number State | TX
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