Provider Demographics
NPI:1710574520
Name:ARISE AND SHINE AFFORDABLE MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:ARISE AND SHINE AFFORDABLE MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:ENYONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-230-4437
Mailing Address - Street 1:8626 TESORO DR STE 205G
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-6217
Mailing Address - Country:US
Mailing Address - Phone:210-290-9310
Mailing Address - Fax:
Practice Address - Street 1:8626 TESORO DR STE 205G
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-6217
Practice Address - Country:US
Practice Address - Phone:210-290-9310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)