Basic Information
Provider Information
NPI: 1942746839
EntityType: 2
ReplacementNPI:  
OrganizationName: SYNERGY TRANSPORTATION SERVICE LLC
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Mailing Information
Address1: 29155 NORTHWESTERN HWY UNIT 781
Address2:  
City: SOUTHFIELD
State: MI
PostalCode: 480341011
CountryCode: US
TelephoneNumber: 3137845560
FaxNumber:  
Practice Location
Address1: 14954 MEYERS RD
Address2:  
City: DETROIT
State: MI
PostalCode: 482274088
CountryCode: US
TelephoneNumber: 3137845560
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/16/2017
LastUpdateDate: 01/16/2017
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: SAUNDERS-DAVENPORT
AuthorizedOfficialFirstName: KHADISHA
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AuthorizedOfficialTitleorPosition: PRSIDENT
AuthorizedOfficialTelephone: 3137845560
IsSoleProprietor:  
IsOrganizationSubpart: N
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AuthorizedOfficialCredential: MA LPC
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
343900000X  Y Transportation ServicesNon-emergency Medical Transport (VAN) 

No ID Information.


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