Provider Demographics
NPI:1801430848
Name:JAMES, HENRY (N/A)
Entity type:Individual
Prefix:MR
First Name:HENRY
Middle Name:
Last Name:JAMES
Suffix:
Gender:M
Credentials:N/A
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:N/A
Mailing Address - Street 1:PO BOX 350157
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32135-0157
Mailing Address - Country:US
Mailing Address - Phone:386-517-3950
Mailing Address - Fax:
Practice Address - Street 1:1 BRESSLER LN
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-8750
Practice Address - Country:US
Practice Address - Phone:386-517-3950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-02
Last Update Date:2019-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17630343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)