Provider Demographics
NPI:1740714666
Name:LEE'S AMBULATE AND TRANSPORTATION SERVICES LLC
Entity type:Organization
Organization Name:LEE'S AMBULATE AND TRANSPORTATION SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DRIVER
Authorized Official - Prefix:MS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:D
Authorized Official - Last Name:BUCKLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-476-4029
Mailing Address - Street 1:PO BOX 7451
Mailing Address - Street 2:BOX 7451
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-0758
Mailing Address - Country:US
Mailing Address - Phone:516-476-4029
Mailing Address - Fax:
Practice Address - Street 1:132 WEST MERRICK ROAD BX7451
Practice Address - Street 2:BOX 7451
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-0758
Practice Address - Country:US
Practice Address - Phone:516-476-4029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251C00000X, 261QA0600X, 291U00000X, 292200000X, 293D00000X, 305R00000X, 311ZA0620X, 343800000X, 343900000X, 347C00000X, 347E00000X, 385HR2060X
NY754348166320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No291U00000XLaboratoriesClinical Medical Laboratory
No292200000XLaboratoriesDental Laboratory
No293D00000XLaboratoriesPhysiological Laboratory
No305R00000XManaged Care OrganizationsPreferred Provider Organization
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1295123214OtherNPI 1295123214