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General NPI Number Information
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NPI Number | 1790539419
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Entity Type | Organization
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Legal Business Name | CANDJ TRANSPORTATIONLLC
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Dates
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Enumeration Date | 04/17/2024
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Last Update Date | 04/17/2024
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Provider Practice Location Address
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Address Line | 23 BALL PARK LN
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City | CHESTERFIELD
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State | SC
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Zip | 29709-6180
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Country | US
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Telephone | 843-622-4691
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Fax | 843-622-4691
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Provider Business Mailing Address
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Address Line | 23 BALL PARK LN
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City | CHESTERFIELD
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State | SC
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Zip | 29709-6180
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Country | US
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Telephone | 843-622-4691
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Fax | 843-622-4691
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Authorized Official
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Title or Position | OWNER
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Name | MRS. CONNIE RATLIFF MCBRIDE
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Credential |
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Telephone | 843-622-4691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State |
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