Organization
DIRECT DESTINATION DELIVERY SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DERALD DEMOND DATCHER (OWNER/OPERATOR)
(682) 551-7179
Entity
Organization
Contact information
Practice address
4936 BRAZOSWOOD CIR, ARLINGTON, TX 76017-1094
(682) 551-7179
Mailing address
4936 BRAZOSWOOD CIR, ARLINGTON, TX 76017-1094
(682) 551-7179
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
21038722
TX
Other
Enumeration date
09/08/2009
Last updated
09/08/2009
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