Provider Demographics
NPI:1376379990
Name:AGILITY TRANSPORT SERVICES LLC
Entity type:Organization
Organization Name:AGILITY TRANSPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NDIDI
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:NWANERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-525-8192
Mailing Address - Street 1:3990 VITRUVIAN WAY APT 617
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4488
Mailing Address - Country:US
Mailing Address - Phone:443-525-8192
Mailing Address - Fax:
Practice Address - Street 1:3990 VITRUVIAN WAY APT 617
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-4488
Practice Address - Country:US
Practice Address - Phone:443-525-8192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-10
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)