Provider Demographics
NPI:1417526302
Name:DJ'S NON-EMERGENCY TRANSPORTATION,LLC
Entity Type:Organization
Organization Name:DJ'S NON-EMERGENCY TRANSPORTATION,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEANGELO
Authorized Official - Middle Name:
Authorized Official - Last Name:FAIRLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-421-9010
Mailing Address - Street 1:3476 AGAPE RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-5210
Mailing Address - Country:US
Mailing Address - Phone:901-421-9010
Mailing Address - Fax:
Practice Address - Street 1:3476 AGAPE RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-5210
Practice Address - Country:US
Practice Address - Phone:901-421-9010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-23
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WV0202XOther Service ProvidersContractorVehicle ModificationsGroup - Single Specialty