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General NPI Number Information
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NPI Number | 1790237873
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Entity Type | Organization
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Legal Business Name | ON THE ROAD AGAIN
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Dates
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Enumeration Date | 10/25/2016
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Last Update Date | 10/25/2016
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Provider Practice Location Address
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Address Line | 7383 N UNION CHURCH RD
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City | MILFORD
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State | DE
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Zip | 19963-3465
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Country | US
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Telephone | 302-258-9350
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Fax | 302-725-5458
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Provider Business Mailing Address
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Address Line | 7383 N UNION CHURCH RD
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City | MILFORD
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State | DE
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Zip | 19963-3465
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Country | US
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Telephone | 302-258-9350
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Fax | 302-725-5458
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MRS. RENEE ARSENEAU GALLAGHER
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Credential |
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Telephone | 302-258-9350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number | 2015103978
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License Number State | DE
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