Provider Demographics
NPI:1073375150
Name:EMVIAN NON-EMERGENCY MEDICAL TRANSPORTATION SERVICES.
Entity Type:Organization
Organization Name:EMVIAN NON-EMERGENCY MEDICAL TRANSPORTATION SERVICES.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:SHANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KETTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-778-3156
Mailing Address - Street 1:317 PENNFIELD ST
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33974-9495
Mailing Address - Country:US
Mailing Address - Phone:239-778-3156
Mailing Address - Fax:
Practice Address - Street 1:317 PENNFIELD ST
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33974-9495
Practice Address - Country:US
Practice Address - Phone:239-778-3156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)