Organization
AGILE SPECIALTY TRANSPORTATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FEONN L. RANDALL (OPERATIONS MGR.)
(314) 443-7565
Entity
Organization
Contact information
Practice address
320 BROOKES DR STE 212, HAZELWOOD, MO 63042-2740
(314) 443-7565
(314) 355-5130
Mailing address
320 BROOKES DR STE 212, HAZELWOOD, MO 63042-2740
(314) 443-7565
(314) 355-5130
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
LC0888387
MO
343900000X
Non-emergency Medical Transport (VAN)
Primary
LC0888387
MO
Other
Enumeration date
05/04/2010
Last updated
05/04/2010
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