Provider Demographics
NPI:1073228078
Name:TWELVE TEN TRANSPORT LLC
Entity Type:Organization
Organization Name:TWELVE TEN TRANSPORT LLC
Other - Org Name:TWELVE TEN TRANSPORT LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:GENE
Authorized Official - Last Name:STRANGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-755-1589
Mailing Address - Street 1:1605 OAKHILL DR
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-3209
Mailing Address - Country:US
Mailing Address - Phone:214-755-1589
Mailing Address - Fax:
Practice Address - Street 1:1605 OAKHILL DR
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-3209
Practice Address - Country:US
Practice Address - Phone:214-755-1589
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-16
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)