Organization
RELIABLERID
Active
Organization
RELIABLERID
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMMANUEL EBUKA BENJAMIN-ECHEDOM (MANAGER)
(817) 366-3512
Entity
Organization
Contact information
Practice address
645 BLASSINGAME AVE APT F212, VAN ALSTYNE, TX 75495-3040
(817) 366-3512
Mailing address
6016 MCKASKLE DR, FORT WORTH, TX 76119-1608
(817) 366-3512
Taxonomy
Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
05/07/2026
Last updated
05/07/2026
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