Provider Demographics
NPI:1942445820
Name:STRETCHER LIMO, INC.
Entity type:Organization
Organization Name:STRETCHER LIMO, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER /
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPIVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-845-1132
Mailing Address - Street 1:6030 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-2524
Mailing Address - Country:US
Mailing Address - Phone:727-845-4454
Mailing Address - Fax:727-841-7225
Practice Address - Street 1:6030 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-2524
Practice Address - Country:US
Practice Address - Phone:727-845-4454
Practice Address - Fax:727-841-7225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL410 107 300Medicaid