Provider Demographics
NPI:1114677101
Name:DIVYNE TRANSPORTATION SERVICES, LLC
Entity Type:Organization
Organization Name:DIVYNE TRANSPORTATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MSN
Authorized Official - Phone:843-319-8642
Mailing Address - Street 1:2215 W PALMETTO ST STE F
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-3971
Mailing Address - Country:US
Mailing Address - Phone:843-319-8642
Mailing Address - Fax:
Practice Address - Street 1:2215 W PALMETTO ST STE F
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-3971
Practice Address - Country:US
Practice Address - Phone:843-407-4046
Practice Address - Fax:843-407-4046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Multi-Specialty