Provider Demographics
NPI:1083493225
Name:NEW GLOW NON EMERGENCY TRANSPORTATION SERVICES LLC
Entity Type:Organization
Organization Name:NEW GLOW NON EMERGENCY TRANSPORTATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLEOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-448-2490
Mailing Address - Street 1:5889 SW 21ST ST
Mailing Address - Street 2:
Mailing Address - City:WEST PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33023-3008
Mailing Address - Country:US
Mailing Address - Phone:954-448-2490
Mailing Address - Fax:
Practice Address - Street 1:5889 SW 21ST ST
Practice Address - Street 2:
Practice Address - City:WEST PARK
Practice Address - State:FL
Practice Address - Zip Code:33023-3008
Practice Address - Country:US
Practice Address - Phone:954-448-2490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)