Provider Demographics
NPI:1952976482
Name:WINGATE TRANSPORTATION LLC
Entity Type:Organization
Organization Name:WINGATE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:FURTADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-240-4260
Mailing Address - Street 1:40 SYCAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-3253
Mailing Address - Country:US
Mailing Address - Phone:774-240-4260
Mailing Address - Fax:
Practice Address - Street 1:40 SYCAMORE AVE
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-3253
Practice Address - Country:US
Practice Address - Phone:774-240-4260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)