Provider Demographics
NPI:1447016571
Name:NORTH CENTRAL TRANSPORT LLC
Entity type:Organization
Organization Name:NORTH CENTRAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEMT PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:INDERDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:JOLLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-681-7916
Mailing Address - Street 1:PO BOX 48222
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32247-8222
Mailing Address - Country:US
Mailing Address - Phone:717-681-7916
Mailing Address - Fax:
Practice Address - Street 1:3715 VINELAND RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-6416
Practice Address - Country:US
Practice Address - Phone:717-681-7916
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)