Provider Demographics
NPI:1831496397
Name:STAMPEDEE TRANSPORTATION
Entity Type:Organization
Organization Name:STAMPEDEE TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-651-6302
Mailing Address - Street 1:100 FRANCIS CT APT 328
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-8981
Mailing Address - Country:US
Mailing Address - Phone:973-651-6302
Mailing Address - Fax:
Practice Address - Street 1:100 FRANCIS CT APT 328
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-8981
Practice Address - Country:US
Practice Address - Phone:973-651-6302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJG7200 15379 09712343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)