Provider Demographics
NPI:1295275709
Name:ACHTRANSPORT
Entity type:Organization
Organization Name:ACHTRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRANSPORTATION PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:CARANIETA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:ROLFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-688-7701
Mailing Address - Street 1:1048 STANFORD LN
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-2966
Mailing Address - Country:US
Mailing Address - Phone:469-688-7701
Mailing Address - Fax:972-992-4848
Practice Address - Street 1:1048 STANFORD LN
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-2966
Practice Address - Country:US
Practice Address - Phone:469-688-7701
Practice Address - Fax:972-992-4848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-02
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15552199343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)