Provider Demographics
NPI:1417447541
Name:BLU TRANSPORT, LLC
Entity Type:Organization
Organization Name:BLU TRANSPORT, LLC
Other - Org Name:BLU MEDICAL TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DARIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:DORIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-721-2229
Mailing Address - Street 1:1821 S BASCOM AVE #151
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-2357
Mailing Address - Country:US
Mailing Address - Phone:408-721-2229
Mailing Address - Fax:
Practice Address - Street 1:654 WHITETHORNE DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-4243
Practice Address - Country:US
Practice Address - Phone:408-721-2229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)