Provider Demographics
NPI:1508090077
Name:CJ'S COURIER GROUP
Entity Type:Organization
Organization Name:CJ'S COURIER GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PRACTICAL NURSE
Authorized Official - Prefix:MISS
Authorized Official - First Name:CHAVIER
Authorized Official - Middle Name:MARVETTE
Authorized Official - Last Name:PUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-702-8057
Mailing Address - Street 1:5244 CHAMPAGNE CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-2857
Mailing Address - Country:US
Mailing Address - Phone:352-702-8057
Mailing Address - Fax:
Practice Address - Street 1:5244 CHAMPAGNE CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-2857
Practice Address - Country:US
Practice Address - Phone:352-702-8057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5880151040534343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)