Provider Demographics
NPI:1598205155
Name:NAGROM WORKS LLC
Entity Type:Organization
Organization Name:NAGROM WORKS LLC
Other - Org Name:NAGROM TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LANAIR
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN SLAUGHTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-537-0525
Mailing Address - Street 1:1018 PASEO DEL SOL
Mailing Address - Street 2:
Mailing Address - City:BANNING
Mailing Address - State:CA
Mailing Address - Zip Code:92220-1856
Mailing Address - Country:US
Mailing Address - Phone:951-537-0525
Mailing Address - Fax:
Practice Address - Street 1:1018 PASEO DEL SOL
Practice Address - Street 2:
Practice Address - City:BANNING
Practice Address - State:CA
Practice Address - Zip Code:92220-1856
Practice Address - Country:US
Practice Address - Phone:951-537-0525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-02
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle