Provider Demographics
NPI:1750017273
Name:COREY'S TRUCKING SERVICE, LLC
Entity type:Organization
Organization Name:COREY'S TRUCKING SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:COREY
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:561-723-1150
Mailing Address - Street 1:850 PALM BLVD
Mailing Address - Street 2:
Mailing Address - City:PAHOKEE
Mailing Address - State:FL
Mailing Address - Zip Code:33476-2519
Mailing Address - Country:US
Mailing Address - Phone:561-723-1150
Mailing Address - Fax:
Practice Address - Street 1:13840 77TH PL N
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33412-2104
Practice Address - Country:US
Practice Address - Phone:561-723-1150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COREY'S TRUCKING SERVICE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-27
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL082956667OtherCOMPANY'S DUN & BRADSTREET D-U-N-S NUMBER