Provider Demographics
NPI:1467899310
Name:COMPANION TRANSPORT, LLC
Entity Type:Organization
Organization Name:COMPANION TRANSPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAREKE
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-766-9002
Mailing Address - Street 1:5205 PROSPECT RD
Mailing Address - Street 2:#135-149
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-5000
Mailing Address - Country:US
Mailing Address - Phone:408-766-9002
Mailing Address - Fax:408-516-9070
Practice Address - Street 1:3296 TRAVIATA PL
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95117-3028
Practice Address - Country:US
Practice Address - Phone:408-766-9002
Practice Address - Fax:408-516-9070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-02
Last Update Date:2013-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)