Provider Demographics
NPI:1639790538
Name:ACCOLADE TRANSPORT LLC
Entity Type:Organization
Organization Name:ACCOLADE TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DZIKITI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-216-9569
Mailing Address - Street 1:3209 PREMIER DR STE 103
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-2355
Mailing Address - Country:US
Mailing Address - Phone:402-216-9569
Mailing Address - Fax:
Practice Address - Street 1:3209 PREMIER DR STE 103
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-2355
Practice Address - Country:US
Practice Address - Phone:402-216-9569
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-01
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)