Provider Demographics
NPI:1205580347
Name:WHEELCHAIR ACCESSIBLE TRANSPORTATION, LLC
Entity type:Organization
Organization Name:WHEELCHAIR ACCESSIBLE TRANSPORTATION, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:GLESS
Authorized Official - Last Name:ESTRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-714-3451
Mailing Address - Street 1:1324 S BECKHAM AVE STE 119
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-3321
Mailing Address - Country:US
Mailing Address - Phone:877-937-6558
Mailing Address - Fax:
Practice Address - Street 1:1324 S BECKHAM AVE STE 119
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-3321
Practice Address - Country:US
Practice Address - Phone:877-937-6558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-08
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347E00000XTransportation ServicesTransportation Broker