Provider Demographics
NPI:1710334271
Name:GOOD SHEPHERD TRANSPORTATION LLC
Entity Type:Organization
Organization Name:GOOD SHEPHERD TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARMAND
Authorized Official - Middle Name:
Authorized Official - Last Name:AUDIGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-284-1466
Mailing Address - Street 1:3709 WEETAMOO CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-8247
Mailing Address - Country:US
Mailing Address - Phone:407-492-9620
Mailing Address - Fax:
Practice Address - Street 1:3709 WEETAMOO CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-8247
Practice Address - Country:US
Practice Address - Phone:407-492-9620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-15
Last Update Date:2016-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
343900000X
FL33143109343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)