Provider Demographics
NPI:1376059238
Name:SPECIAL DRIVING SERVICES, INC.
Entity Type:Organization
Organization Name:SPECIAL DRIVING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:EDS, CDRS,CBIS, CDI
Authorized Official - Phone:517-489-1700
Mailing Address - Street 1:PO BOX 241
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48805-0241
Mailing Address - Country:US
Mailing Address - Phone:517-349-7990
Mailing Address - Fax:517-489-4781
Practice Address - Street 1:3945 OKEMOS RD STE A5
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-4207
Practice Address - Country:US
Practice Address - Phone:517-349-7990
Practice Address - Fax:517-489-4781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-14
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIP000648305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service