Provider Demographics
NPI:1043911175
Name:GRATEFUL TRANSPORTATION SERVICES INC
Entity Type:Organization
Organization Name:GRATEFUL TRANSPORTATION SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:D
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:501-237-1878
Mailing Address - Street 1:2519 S SHIELDS ST STE 1K
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-1855
Mailing Address - Country:US
Mailing Address - Phone:501-237-1878
Mailing Address - Fax:501-521-1533
Practice Address - Street 1:1519 UNION AVE UNIT 544
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3726
Practice Address - Country:US
Practice Address - Phone:501-237-1878
Practice Address - Fax:501-521-1533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)