NPI 1205154002 · live from the CMS NPI Registry
Agile Specialty Transportation, LLC
Non-emergency Medical Transport (VAN) in Hazelwood, MO. National Provider Identifier 1205154002, active.
NPI record
| NPI | 1205154002 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Non-emergency Medical Transport (VAN) 343900000X |
| Practice location | 320 Brookes Dr Ste 212, Hazelwood, MO 63042 |
| Practice phone | 314-443-7565 |
| Enumerated | May 4, 2010 |
| Last updated | May 4, 2010 |
| Authorized official | Feonn Randall, Operations Mgr. |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Ambulance | 341600000X | LC0888387 (MO) |
| Non-emergency Medical Transport (VAN) primary | 343900000X | LC0888387 (MO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.