Provider Demographics
NPI:1558919019
Name:GPS TRANSPORTATION, LLC
Entity Type:Organization
Organization Name:GPS TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAKENA
Authorized Official - Middle Name:
Authorized Official - Last Name:DANTZLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-628-3511
Mailing Address - Street 1:10200 FOREST GREEN BLVD STE 112
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5167
Mailing Address - Country:US
Mailing Address - Phone:917-628-3511
Mailing Address - Fax:803-675-0952
Practice Address - Street 1:10200 FOREST GREEN BLVD STE 112
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-5167
Practice Address - Country:US
Practice Address - Phone:917-628-3511
Practice Address - Fax:803-675-0952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-28
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100528490Medicaid
KY7100544810Medicaid
KY7100544960Medicaid