Provider Demographics
NPI:1013546837
Name:DIVINE HANDS TRANSPORT LLC
Entity Type:Organization
Organization Name:DIVINE HANDS TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ISICHEI
Authorized Official - Middle Name:S
Authorized Official - Last Name:ANENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-351-4814
Mailing Address - Street 1:104 INDUSTRIAL BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3170
Mailing Address - Country:US
Mailing Address - Phone:907-351-4814
Mailing Address - Fax:
Practice Address - Street 1:104 INDUSTRIAL BLVD STE D
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3170
Practice Address - Country:US
Practice Address - Phone:907-351-4814
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-03
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)