Provider Demographics
NPI:1255912069
Name:DRIVE SAFE TRANSPORTATION
Entity type:Organization
Organization Name:DRIVE SAFE TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TORRE
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-250-5484
Mailing Address - Street 1:4571 CHANNING LN
Mailing Address - Street 2:
Mailing Address - City:TROTWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45416-1654
Mailing Address - Country:US
Mailing Address - Phone:937-250-5484
Mailing Address - Fax:
Practice Address - Street 1:4571 CHANNING LN
Practice Address - Street 2:
Practice Address - City:TROTWOOD
Practice Address - State:OH
Practice Address - Zip Code:45416-1654
Practice Address - Country:US
Practice Address - Phone:937-250-5484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty