Provider Demographics
NPI:1043836554
Name:GG PARAMOUNT CARE TRANSPORTATION LLC.
Entity Type:Organization
Organization Name:GG PARAMOUNT CARE TRANSPORTATION LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBENSON
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:LEBRUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-738-1440
Mailing Address - Street 1:PO BOX 1656
Mailing Address - Street 2:
Mailing Address - City:IMMOKALEE
Mailing Address - State:FL
Mailing Address - Zip Code:34143-1656
Mailing Address - Country:US
Mailing Address - Phone:239-961-6535
Mailing Address - Fax:
Practice Address - Street 1:1376 AMERICA WAY
Practice Address - Street 2:
Practice Address - City:IMMOKALEE
Practice Address - State:FL
Practice Address - Zip Code:34142-2421
Practice Address - Country:US
Practice Address - Phone:239-961-6535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-19
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)