Provider Demographics
NPI:1134981772
Name:VAN-GO DELIVERY
Entity type:Organization
Organization Name:VAN-GO DELIVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SERINGE
Authorized Official - Middle Name:BASSIROU
Authorized Official - Last Name:LO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-656-1523
Mailing Address - Street 1:9901 GRASSLAND DR APT 1
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-2847
Mailing Address - Country:US
Mailing Address - Phone:502-656-1523
Mailing Address - Fax:
Practice Address - Street 1:9901 GRASSLAND DR APT 1
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-2847
Practice Address - Country:US
Practice Address - Phone:502-656-1523
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)