Provider Demographics
NPI:1497410039
Name:ROAD2WELLNESS SERVICES L.L.C.
Entity type:Organization
Organization Name:ROAD2WELLNESS SERVICES L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTNI
Authorized Official - Middle Name:R
Authorized Official - Last Name:AUZENNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-290-8402
Mailing Address - Street 1:3625 SCHOOLHOUSE RD W UNIT 106
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33916-8186
Mailing Address - Country:US
Mailing Address - Phone:337-290-8402
Mailing Address - Fax:
Practice Address - Street 1:3625 SCHOOLHOUSE RD W UNIT 106
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33916-8186
Practice Address - Country:US
Practice Address - Phone:337-290-8402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)