=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942009030
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | 818 TRANSPORT LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/11/2025
-----------------------------------------------------
Last Update Date | 03/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6512 HARSHMANVILLE ROAD
-----------------------------------------------------
City | DAYTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45424
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-789-4655
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8235 OLD TROY PIKE # 118
-----------------------------------------------------
City | DAYTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45424-1025
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-789-4655
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DAMON WOODALL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 937-789-4655
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------