Provider Demographics
NPI:1457076572
Name:GO GRIMES TRANSPORTATION
Entity Type:Organization
Organization Name:GO GRIMES TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DYNESTY
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRUCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-266-1237
Mailing Address - Street 1:2129 FENELON ST
Mailing Address - Street 2:
Mailing Address - City:CHALMETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70043-4947
Mailing Address - Country:US
Mailing Address - Phone:504-266-1237
Mailing Address - Fax:
Practice Address - Street 1:2129 FENELON ST
Practice Address - Street 2:
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-4947
Practice Address - Country:US
Practice Address - Phone:504-266-1237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)