Provider Demographics
NPI:1396367272
Name:SMARTPORT LLC
Entity Type:Organization
Organization Name:SMARTPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:W
Authorized Official - Last Name:MOLLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-325-8001
Mailing Address - Street 1:C/O MOLLO
Mailing Address - Street 2:1111 SUMMER ST
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905
Mailing Address - Country:US
Mailing Address - Phone:203-325-8001
Mailing Address - Fax:203-978-0104
Practice Address - Street 1:C/O MOLLO
Practice Address - Street 2:1111 SUMMER ST
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905
Practice Address - Country:US
Practice Address - Phone:203-325-8001
Practice Address - Fax:203-978-0104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)