Provider Demographics
NPI:1770383812
Name:HERITAGE DUO GROUP LLC
Entity type:Organization
Organization Name:HERITAGE DUO GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:OLUMIDE
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAVIES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-517-6585
Mailing Address - Street 1:9115 FM 723 RD STE 550
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-9238
Mailing Address - Country:US
Mailing Address - Phone:973-517-6585
Mailing Address - Fax:
Practice Address - Street 1:10435 CARINA CLOUD LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-3170
Practice Address - Country:US
Practice Address - Phone:973-517-6585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi
No347B00000XTransportation ServicesBus
No347C00000XTransportation ServicesPrivate Vehicle