Provider Demographics
NPI:1114139771
Name:BOUNDLESS TRANSPORT,LLC
Entity Type:Organization
Organization Name:BOUNDLESS TRANSPORT,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:IMELDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SANIDAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-935-8216
Mailing Address - Street 1:1031 CERVANTEZ CT
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-3450
Mailing Address - Country:US
Mailing Address - Phone:408-935-8216
Mailing Address - Fax:408-262-6323
Practice Address - Street 1:1031 CERVANTEZ CT
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-3450
Practice Address - Country:US
Practice Address - Phone:408-935-8216
Practice Address - Fax:408-262-6323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29989343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)