Provider Demographics
NPI:1912767419
Name:AURIDAN COLLABORATIVE, L.L.C
Entity Type:Organization
Organization Name:AURIDAN COLLABORATIVE, L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:DOCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAKYI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-742-0291
Mailing Address - Street 1:PO BOX 2562
Mailing Address - Street 2:
Mailing Address - City:SPOTSYLVANIA
Mailing Address - State:VA
Mailing Address - Zip Code:22553-6814
Mailing Address - Country:US
Mailing Address - Phone:804-742-0291
Mailing Address - Fax:
Practice Address - Street 1:4445 CORPORATION LN STE 259
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3671
Practice Address - Country:US
Practice Address - Phone:804-742-0291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)