Provider Demographics
NPI:1740529320
Name:EMCOL INVESTMENTS, LLC.
Entity type:Organization
Organization Name:EMCOL INVESTMENTS, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:OLUGBENGA
Authorized Official - Middle Name:B
Authorized Official - Last Name:AJAYI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-572-1888
Mailing Address - Street 1:619 MERCURY AVE
Mailing Address - Street 2:SUITE # 104
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75137-2240
Mailing Address - Country:US
Mailing Address - Phone:817-691-1595
Mailing Address - Fax:972-572-1888
Practice Address - Street 1:1401 GRAND CANYON CT
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76002-5118
Practice Address - Country:US
Practice Address - Phone:817-691-1595
Practice Address - Fax:972-572-1888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-02
Last Update Date:2013-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18171392343900000X, 347C00000X, 347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No347E00000XTransportation ServicesTransportation Broker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX11111111111111111111Medicaid