Provider Demographics
NPI:1033547583
Name:ENDURANCE TRANSPORTATION, LLC
Entity Type:Organization
Organization Name:ENDURANCE TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:GATES
Authorized Official - Last Name:PARTLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-871-3358
Mailing Address - Street 1:805 N GREEN ST
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-2611
Mailing Address - Country:US
Mailing Address - Phone:662-840-9224
Mailing Address - Fax:662-840-9699
Practice Address - Street 1:2107 PRESIDENT AVE
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-6456
Practice Address - Country:US
Practice Address - Phone:662-871-3358
Practice Address - Fax:662-840-9699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-19
Last Update Date:2013-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)