Provider Demographics
NPI:1861162059
Name:SUR LOGISTICS LLC
Entity type:Organization
Organization Name:SUR LOGISTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VIC PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:COLVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-977-1778
Mailing Address - Street 1:1993 SPICETREE LN SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97306-3406
Mailing Address - Country:US
Mailing Address - Phone:541-977-1778
Mailing Address - Fax:
Practice Address - Street 1:1993 SPICETREE LN SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97306-3406
Practice Address - Country:US
Practice Address - Phone:541-977-1778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-17
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)