Provider Demographics
NPI:1225279318
Name:AFFORDABLE TRANSPORT INC.
Entity Type:Organization
Organization Name:AFFORDABLE TRANSPORT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:F
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:863-698-9765
Mailing Address - Street 1:3706 DMG DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33811-1043
Mailing Address - Country:US
Mailing Address - Phone:863-698-9764
Mailing Address - Fax:863-519-0053
Practice Address - Street 1:3706 DMG DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33811-1043
Practice Address - Country:US
Practice Address - Phone:863-698-9764
Practice Address - Fax:863-519-0053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3416L0300X
FL343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)