Provider Demographics
NPI:1033867908
Name:SECURE TRANSPORATION
Entity Type:Organization
Organization Name:SECURE TRANSPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHACKLEFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-705-6639
Mailing Address - Street 1:19TH STREET STE.3
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35020-3139
Mailing Address - Country:US
Mailing Address - Phone:205-427-6644
Mailing Address - Fax:
Practice Address - Street 1:1532V CAROL CIR
Practice Address - Street 2:
Practice Address - City:MIDFIELD
Practice Address - State:AL
Practice Address - Zip Code:35228-3139
Practice Address - Country:US
Practice Address - Phone:205-427-6644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-10
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No341600000XTransportation ServicesAmbulance