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General NPI Number Information
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NPI Number | 1790087161
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Entity Type | Organization
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Legal Business Name | COVENANT TRANSPORTATION LLC
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Dates
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Enumeration Date | 11/17/2010
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Last Update Date | 11/17/2010
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Provider Practice Location Address
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Address Line | 3920 BEE RIDGE RD C-D
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City | SARASOTA
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State | FL
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Zip | 34233-1207
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Country | US
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Telephone | 941-924-4990
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Fax | 941-922-5751
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Provider Business Mailing Address
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Address Line | 3920 BEE RIDGE RD C-D
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City | SARASOTA
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State | FL
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Zip | 34233-1207
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Country | US
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Telephone | 941-924-4990
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Fax | 941-922-5751
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | MR. DEAN OLINGER
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Credential |
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Telephone | 941-924-4990
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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 | 58-NS-00209
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License Number State | FL
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