Provider Demographics
NPI:1326647496
Name:DICKERSONS TRANSPORTATION LLC
Entity Type:Organization
Organization Name:DICKERSONS TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:DICKERSON
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:661-384-4835
Mailing Address - Street 1:234 BAKER ST STE 5
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93305-5856
Mailing Address - Country:US
Mailing Address - Phone:661-384-4835
Mailing Address - Fax:
Practice Address - Street 1:234 BAKER ST STE 5
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-5856
Practice Address - Country:US
Practice Address - Phone:661-384-4835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)