=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891243234
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GET THERE SAFE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/14/2016
-----------------------------------------------------
Last Update Date | 09/14/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1425 PASSPORT LN
-----------------------------------------------------
City | DAYTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45414-5914
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-443-1012
-----------------------------------------------------
Fax | 937-387-6122
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1425 PASSPORT LN
-----------------------------------------------------
City | DAYTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45414-5914
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-443-1012
-----------------------------------------------------
Fax | 937-387-6122
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR/OWNER
-----------------------------------------------------
Name | MS. ANGELA RENEE HOOKS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 937-443-1012
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number | 575555
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------