Provider Demographics
NPI:1417331703
Name:SPAN, INCORPORATED
Entity Type:Organization
Organization Name:SPAN, INCORPORATED
Other - Org Name:SPAN DENTON COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-382-2224
Mailing Address - Street 1:1800 MALONE ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-1746
Mailing Address - Country:US
Mailing Address - Phone:940-382-2224
Mailing Address - Fax:940-383-8433
Practice Address - Street 1:1800 MALONE ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-1746
Practice Address - Country:US
Practice Address - Phone:940-382-2224
Practice Address - Fax:940-383-8433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)