Provider Demographics
NPI:1942024195
Name:EL SHADDAI NEMT TRANSPORTATION
Entity type:Organization
Organization Name:EL SHADDAI NEMT TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:SAINTIDOR
Authorized Official - Suffix:
Authorized Official - Credentials:NEMT TRANSPORTATION
Authorized Official - Phone:727-222-8874
Mailing Address - Street 1:702 CRISTELLE JEAN DR
Mailing Address - Street 2:
Mailing Address - City:RUSKIN
Mailing Address - State:FL
Mailing Address - Zip Code:33570-7930
Mailing Address - Country:US
Mailing Address - Phone:727-222-8874
Mailing Address - Fax:
Practice Address - Street 1:1206 BAYOU PASS DR
Practice Address - Street 2:
Practice Address - City:RUSKIN
Practice Address - State:FL
Practice Address - Zip Code:33570-5409
Practice Address - Country:US
Practice Address - Phone:727-222-8874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)