Provider Demographics
NPI:1689039190
Name:ACS MED TRANSPORTATION
Entity Type:Organization
Organization Name:ACS MED TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGWAIFE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:214-507-6636
Mailing Address - Street 1:303 E DANIELDALE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75137-4005
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:303 E DANIELDALE RD
Practice Address - Street 2:SUITE B
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75137-4005
Practice Address - Country:US
Practice Address - Phone:214-507-6636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-28
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle