Provider Demographics
NPI:1609646728
Name:WOC903 TRANSPORT LLC
Entity Type:Organization
Organization Name:WOC903 TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-985-2523
Mailing Address - Street 1:5317 W GOFORTH RD
Mailing Address - Street 2:
Mailing Address - City:KILGORE
Mailing Address - State:TX
Mailing Address - Zip Code:75662-0841
Mailing Address - Country:US
Mailing Address - Phone:903-985-2523
Mailing Address - Fax:
Practice Address - Street 1:5317 W GOFORTH RD
Practice Address - Street 2:
Practice Address - City:KILGORE
Practice Address - State:TX
Practice Address - Zip Code:75662-0841
Practice Address - Country:US
Practice Address - Phone:903-985-2523
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)