Provider Demographics
NPI:1023711595
Name:HENDRICKSON TRANSPORTATION GROUP LLC
Entity type:Organization
Organization Name:HENDRICKSON TRANSPORTATION GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF PLANNING & DEVELOPMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:DVORSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-722-2269
Mailing Address - Street 1:4107 GREENLEAF DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-1450
Mailing Address - Country:US
Mailing Address - Phone:254-722-2269
Mailing Address - Fax:
Practice Address - Street 1:1901 TARBORO ST SW STE 201
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-3479
Practice Address - Country:US
Practice Address - Phone:815-762-0987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-23
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)