Provider Demographics
NPI:1336689249
Name:SYNERGIC CORPORATION
Entity Type:Organization
Organization Name:SYNERGIC CORPORATION
Other - Org Name:EASYPORT TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WENDELL
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:877-447-8424
Mailing Address - Street 1:301 9TH ST STE 414
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-4499
Mailing Address - Country:US
Mailing Address - Phone:877-447-8424
Mailing Address - Fax:877-700-4331
Practice Address - Street 1:301 9TH ST STE 414
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-4499
Practice Address - Country:US
Practice Address - Phone:877-447-8424
Practice Address - Fax:877-700-4331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-27
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherIRS