Provider Demographics
NPI:1669220620
Name:DEWAY 2 GO TRANSPORT LLC
Entity type:Organization
Organization Name:DEWAY 2 GO TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:KIMMERY
Authorized Official - Middle Name:LANELL
Authorized Official - Last Name:OFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-924-5391
Mailing Address - Street 1:13549 RONALD CIR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75709-5067
Mailing Address - Country:US
Mailing Address - Phone:214-924-5391
Mailing Address - Fax:
Practice Address - Street 1:13549 RONALD CIR
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75709-5067
Practice Address - Country:US
Practice Address - Phone:214-924-5391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-07
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)Group - Multi-Specialty