Provider Demographics
NPI:1417719204
Name:GIFTED GALA TRANSPORTATION LLC
Entity Type:Organization
Organization Name:GIFTED GALA TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MWAURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-483-8419
Mailing Address - Street 1:26 BURGESS FARM RD
Mailing Address - Street 2:
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-2177
Mailing Address - Country:US
Mailing Address - Phone:978-483-8419
Mailing Address - Fax:
Practice Address - Street 1:20 COMMERCIAL DR STE 209
Practice Address - Street 2:
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-2837
Practice Address - Country:US
Practice Address - Phone:978-483-8419
Practice Address - Fax:978-710-4829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)