Provider Demographics
NPI:1255991444
Name:SAFE DRIVE NON EMERGENCY MEDICAL TRANSPORTATION LLC
Entity type:Organization
Organization Name:SAFE DRIVE NON EMERGENCY MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:TIMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-253-1227
Mailing Address - Street 1:3107 ASPEN DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72404-7708
Mailing Address - Country:US
Mailing Address - Phone:870-203-3820
Mailing Address - Fax:
Practice Address - Street 1:2210 BRAZOS ST
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-6303
Practice Address - Country:US
Practice Address - Phone:870-253-1227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)