Provider Demographics
NPI:1073858833
Name:ARCHERY TRANSPORT LLC
Entity Type:Organization
Organization Name:ARCHERY TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-I
Authorized Official - Phone:903-724-9058
Mailing Address - Street 1:PO BOX 2737
Mailing Address - Street 2:
Mailing Address - City:PALESTINE
Mailing Address - State:TX
Mailing Address - Zip Code:75802-2737
Mailing Address - Country:US
Mailing Address - Phone:903-724-9058
Mailing Address - Fax:903-322-4718
Practice Address - Street 1:625 CEDAR CREEK RD
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:TX
Practice Address - Zip Code:75831-7509
Practice Address - Country:US
Practice Address - Phone:903-724-9058
Practice Address - Fax:903-322-4718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10008703416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport