Provider Demographics
NPI:1295123214
Name:LEE'S AMBULATE AND TRANSPORTATION SVC.
Entity type:Organization
Organization Name:LEE'S AMBULATE AND TRANSPORTATION SVC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DRIVER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCKLES
Authorized Official - Suffix:
Authorized Official - Credentials:TRANSPORTATION OWNER
Authorized Official - Phone:516-476-4029
Mailing Address - Street 1:PO BOX 7451
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-7451
Mailing Address - Country:US
Mailing Address - Phone:516-476-4029
Mailing Address - Fax:516-476-4029
Practice Address - Street 1:107 BROADWAY APT 6
Practice Address - Street 2:APT 6
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-7451
Practice Address - Country:US
Practice Address - Phone:516-476-4029
Practice Address - Fax:516-476-4029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-29
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY347C00000X, 347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker
No347C00000XTransportation ServicesPrivate Vehicle