Provider Demographics
NPI:1710478011
Name:SWEETS DESTIN LLC
Entity Type:Organization
Organization Name:SWEETS DESTIN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-235-0959
Mailing Address - Street 1:1005 COLLINGWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23324-3404
Mailing Address - Country:US
Mailing Address - Phone:757-927-1440
Mailing Address - Fax:757-545-6318
Practice Address - Street 1:1005 COLLINGWOOD AVE
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23324-3404
Practice Address - Country:US
Practice Address - Phone:757-927-1440
Practice Address - Fax:757-545-6318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-22
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)