Organization
WHITE GLOVE TRANSPORTATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA M HENSCHEN COTA/L (OWNER)
(260) 433-8490
Entity
Organization
Contact information
Practice address
7405 ANTEBELLUM DR, FORT WAYNE, IN 46815-6568
(260) 493-1181
(219) 627-9217
Mailing address
7405 ANTEBELLUM DR, FORT WAYNE, IN 46815-6568
(260) 493-1181
(219) 627-9217
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
8970007677
IN
Other
Enumeration date
12/02/2016
Last updated
12/02/2016
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