Provider Demographics
NPI:1376965921
Name:ALLIED WHEELCHAIR VAN SERVICE LLC
Entity Type:Organization
Organization Name:ALLIED WHEELCHAIR VAN SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:DEARBORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-498-7918
Mailing Address - Street 1:PO BOX 851
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-0851
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:725 LAFAYETTE RD
Practice Address - Street 2:UNIT 208
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842-1295
Practice Address - Country:US
Practice Address - Phone:603-498-7918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-16
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)