Organization
GRAY WOLF TRANSPORTATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRZA MIRZA (CHIEF EXECUTIVE OFFICER)
(937) 396-4847
Entity
Organization
Contact information
Practice address
115 AVONDALE DR, DAYTON, OH 45404-2123
(888) 415-9644
(888) 415-0950
Mailing address
303 DEEDS AVE, DAYTON, OH 45404-1719
(937) 396-4847
(888) 415-0950
Taxonomy
Speciality
Code
Description
License number
State
261QA0005X
Ambulatory Family Planning Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
12/05/2018
Last updated
01/03/2024
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