Provider Demographics
NPI:1225810104
Name:SUDDY LLC
Entity Type:Organization
Organization Name:SUDDY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHARNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:IVERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-793-6658
Mailing Address - Street 1:PO BOX 16323
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33318-6323
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 S ANDREWS AVE STE 504-1006
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-1864
Practice Address - Country:US
Practice Address - Phone:844-616-0005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)