Provider Demographics
NPI:1902352040
Name:CENTENNIAL PATIENT TRANSPORTATION SERVICES CORPORATION
Entity Type:Organization
Organization Name:CENTENNIAL PATIENT TRANSPORTATION SERVICES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:INITA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-339-2776
Mailing Address - Street 1:4650 S HAMPTON RD STE 101
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75232-1061
Mailing Address - Country:US
Mailing Address - Phone:214-339-2776
Mailing Address - Fax:214-339-2784
Practice Address - Street 1:4650 S HAMPTON RD
Practice Address - Street 2:STE 101
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75232-1066
Practice Address - Country:US
Practice Address - Phone:214-339-2776
Practice Address - Fax:214-339-2784
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENNTENNIAL HOME HEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-08-29
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)