Provider Demographics
NPI:1659684405
Name:SCHRECKENGHAUST MICHEL & PACK INC
Entity Type:Organization
Organization Name:SCHRECKENGHAUST MICHEL & PACK INC
Other - Org Name:THE RIDE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:REX
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHRECKENGHAUST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-485-1911
Mailing Address - Street 1:PO BOX 38
Mailing Address - Street 2:
Mailing Address - City:NOKOMIS
Mailing Address - State:FL
Mailing Address - Zip Code:34274-0038
Mailing Address - Country:US
Mailing Address - Phone:941-485-1911
Mailing Address - Fax:941-485-1935
Practice Address - Street 1:333 TAMIAMI TRL S
Practice Address - Street 2:SUITE 272
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2402
Practice Address - Country:US
Practice Address - Phone:941-485-1911
Practice Address - Fax:941-485-1935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347B00000XTransportation ServicesBus
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001218100OtherAGENCY FOR PERSONS WITH DISABILITIES - STATE OF FLORIDA