Provider Demographics
NPI:1881865749
Name:SANDERS, DONALD LEROY
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:LEROY
Last Name:SANDERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1038 NE HWY E
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:MO
Mailing Address - Zip Code:65360-3210
Mailing Address - Country:US
Mailing Address - Phone:660-647-5553
Mailing Address - Fax:660-647-2213
Practice Address - Street 1:1038 NE HWY E
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:MO
Practice Address - Zip Code:65360-3210
Practice Address - Country:US
Practice Address - Phone:660-647-5553
Practice Address - Fax:660-647-2213
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-19
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)