Provider Demographics
NPI:1982236675
Name:DNA TRANSPORTATION L.L.C
Entity Type:Organization
Organization Name:DNA TRANSPORTATION L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DARELL
Authorized Official - Middle Name:LAMONT
Authorized Official - Last Name:WILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-575-8724
Mailing Address - Street 1:4845 PATRICIA RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BLACK JACK
Mailing Address - State:MO
Mailing Address - Zip Code:63033-7217
Mailing Address - Country:US
Mailing Address - Phone:314-575-8724
Mailing Address - Fax:
Practice Address - Street 1:4845 PATRICIA RIDGE DR
Practice Address - Street 2:
Practice Address - City:BLACK JACK
Practice Address - State:MO
Practice Address - Zip Code:63033-7217
Practice Address - Country:US
Practice Address - Phone:314-575-8724
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-10
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)