Provider Demographics
NPI:1295509792
Name:GOLDEN HEART TRANSPORTATION LLC
Entity type:Organization
Organization Name:GOLDEN HEART TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-908-1949
Mailing Address - Street 1:2915 N CLASSEN BLVD STE 120-F
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106-5400
Mailing Address - Country:US
Mailing Address - Phone:773-908-1949
Mailing Address - Fax:
Practice Address - Street 1:13014 E 122ND PL N
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:OK
Practice Address - Zip Code:74021-8008
Practice Address - Country:US
Practice Address - Phone:773-908-1949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)