Provider Demographics
NPI:1841912920
Name:BLACK FREIGHT LLC
Entity type:Organization
Organization Name:BLACK FREIGHT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BERTONY
Authorized Official - Middle Name:
Authorized Official - Last Name:DIEUDONNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-229-0933
Mailing Address - Street 1:240 N LAKE SHORE WAY
Mailing Address - Street 2:
Mailing Address - City:LAKE ALFRED
Mailing Address - State:FL
Mailing Address - Zip Code:33850-2036
Mailing Address - Country:US
Mailing Address - Phone:727-229-0933
Mailing Address - Fax:863-229-5992
Practice Address - Street 1:240 N LAKE SHORE WAY
Practice Address - Street 2:
Practice Address - City:LAKE ALFRED
Practice Address - State:FL
Practice Address - Zip Code:33850-2036
Practice Address - Country:US
Practice Address - Phone:727-229-0933
Practice Address - Fax:863-229-5992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)