Provider Demographics
NPI:1477226348
Name:OVERT MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:OVERT MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GOODNESS
Authorized Official - Middle Name:
Authorized Official - Last Name:NGOBILI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-971-9554
Mailing Address - Street 1:4410 VALLEY RILL RD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-1956
Mailing Address - Country:US
Mailing Address - Phone:346-971-9554
Mailing Address - Fax:
Practice Address - Street 1:4410 VALLEY RILL RD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-1956
Practice Address - Country:US
Practice Address - Phone:346-971-9554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)