Provider Demographics
NPI:1578013165
Name:CAROL'S DESTIMATION TRANSPORTATION SERVICE LLC
Entity Type:Organization
Organization Name:CAROL'S DESTIMATION TRANSPORTATION SERVICE LLC
Other - Org Name:CDTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:A
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-876-2852
Mailing Address - Street 1:728 ARCTIC ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06608-2008
Mailing Address - Country:US
Mailing Address - Phone:347-876-2852
Mailing Address - Fax:
Practice Address - Street 1:728 ARCTIC ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06608-2008
Practice Address - Country:US
Practice Address - Phone:347-876-2852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)