Provider Demographics
NPI:1457008401
Name:DELUXE TRANSPORT SERVICE L.L.C
Entity type:Organization
Organization Name:DELUXE TRANSPORT SERVICE L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:H
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-250-9093
Mailing Address - Street 1:6041 RIBBON GROVE LN
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-8519
Mailing Address - Country:US
Mailing Address - Phone:408-250-9093
Mailing Address - Fax:
Practice Address - Street 1:6041 RIBBON GROVE LN
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-8519
Practice Address - Country:US
Practice Address - Phone:408-250-9093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)