Organization
GREAT GUARDIAN TRANSPORTATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALLAS DARIUS WILKINS (OWNER)
(269) 906-5370
Entity
Organization
Contact information
Practice address
4021 NICHOLS RD, KALAMAZOO, MI 49004-3107
(269) 906-5370
Mailing address
4021 NICHOLS RD, KALAMAZOO, MI 49004-3107
(269) 906-5370
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8416576
—
MI
Enumeration date
09/11/2018
Last updated
09/11/2018
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