Provider Demographics
NPI:1720726573
Name:SANDRA SECOND START TRANSPORTATIONS CORPORATION
Entity Type:Organization
Organization Name:SANDRA SECOND START TRANSPORTATIONS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVIONA
Authorized Official - Middle Name:EARLINE
Authorized Official - Last Name:JONEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-730-1177
Mailing Address - Street 1:6411 ELRINGTON HEIGHTS LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-3621
Mailing Address - Country:US
Mailing Address - Phone:316-730-1177
Mailing Address - Fax:
Practice Address - Street 1:6411 ELRINGTON HEIGHTS LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-3621
Practice Address - Country:US
Practice Address - Phone:316-730-1177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)