Provider Demographics
NPI:1942985775
Name:DESIRE MEDICAL TRANSPORT LLC
Entity Type:Organization
Organization Name:DESIRE MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PRINCESS
Authorized Official - Middle Name:
Authorized Official - Last Name:GBOR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:469-267-8447
Mailing Address - Street 1:3814 CATALINA ST
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088-8362
Mailing Address - Country:US
Mailing Address - Phone:469-267-8447
Mailing Address - Fax:
Practice Address - Street 1:3814 CATALINA ST
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-8362
Practice Address - Country:US
Practice Address - Phone:469-267-8447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)