Provider Demographics
NPI:1881049237
Name:SERENITY LLC
Entity type:Organization
Organization Name:SERENITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKHAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:VIKHRAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-866-9964
Mailing Address - Street 1:668 MAIN ST # 220
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01887-3395
Mailing Address - Country:US
Mailing Address - Phone:781-866-9964
Mailing Address - Fax:
Practice Address - Street 1:668 MAIN ST # 220
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:MA
Practice Address - Zip Code:01887-3395
Practice Address - Country:US
Practice Address - Phone:781-866-9964
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-03
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)