Provider Demographics
NPI:1083984777
Name:ROLL WITH US,LLC.
Entity Type:Organization
Organization Name:ROLL WITH US,LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RPC
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GAINES
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:765-265-1348
Mailing Address - Street 1:3619 W COUNTY ROAD 300 N
Mailing Address - Street 2:
Mailing Address - City:CONNERSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47331-9742
Mailing Address - Country:US
Mailing Address - Phone:765-265-1348
Mailing Address - Fax:
Practice Address - Street 1:3619 W COUNTY ROAD 300 N
Practice Address - Street 2:
Practice Address - City:CONNERSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47331-9742
Practice Address - Country:US
Practice Address - Phone:765-265-1348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0300127728343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)