Provider Demographics
NPI:1649504002
Name:XPEDITIOUS
Entity type:Organization
Organization Name:XPEDITIOUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:BRADFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-697-6888
Mailing Address - Street 1:PO BOX 635
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48112-0635
Mailing Address - Country:US
Mailing Address - Phone:734-697-6888
Mailing Address - Fax:734-697-6889
Practice Address - Street 1:510 MAIN ST
Practice Address - Street 2:SUITE 9
Practice Address - City:BELLEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48111-5601
Practice Address - Country:US
Practice Address - Phone:734-697-6888
Practice Address - Fax:734-697-6889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI45725-42774343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)