Provider Demographics
NPI:1790598480
Name:DEE LORDS NON EMERGENCY TRANSPORT
Entity type:Organization
Organization Name:DEE LORDS NON EMERGENCY TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:BISI
Authorized Official - Middle Name:O
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-858-1199
Mailing Address - Street 1:10028 KANE WAY
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95209-4513
Mailing Address - Country:US
Mailing Address - Phone:209-858-1199
Mailing Address - Fax:
Practice Address - Street 1:10028 KANE WAY
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95209-4513
Practice Address - Country:US
Practice Address - Phone:209-858-1199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-28
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)