Provider Demographics
NPI:1295380210
Name:BOFREXTON LLC
Entity Type:Organization
Organization Name:BOFREXTON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:
Authorized Official - First Name:BABATOPE
Authorized Official - Middle Name:
Authorized Official - Last Name:OMOJOKUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-607-6340
Mailing Address - Street 1:2401 S COLLINS ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-1245
Mailing Address - Country:US
Mailing Address - Phone:972-607-6340
Mailing Address - Fax:
Practice Address - Street 1:2401 S COLLINS ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-1245
Practice Address - Country:US
Practice Address - Phone:972-607-6340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-06
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)