Gray Wolf Transportation LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

GRAY WOLF TRANSPORTATION LLC

Practice address

115 Avondale Dr
Dayton, OH 45404-2123

Phone

(888) 415-9644

Fax

(888) 415-0950

NPI assigned

Dec 5, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mirza Mirza

Title

Chief Executive Officer

Phone

(937) 396-4847

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1543968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704240000000",
    "number": "1821568635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 DEEDS AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041719",
            "telephone_number": "937-396-4847",
            "fax_number": "888-415-0950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 AVONDALE DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454042123",
            "telephone_number": "888-415-9644",
            "fax_number": "888-415-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAY WOLF TRANSPORTATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-05",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A",
        "authorized_official_last_name": "MIRZA",
        "authorized_official_first_name": "MIRZA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "937-396-4847"
    },
    "taxonomies": [
        {
            "code": "261QA0005X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Family Planning Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greg Alan Grant, CCP
• Larrilyn Louise Grant, MD
• Michael Grant
• Tyler Grant, LSW
• Heaven Graves
• Alisha Brooke Gray, CRNA
• Andrea L Gray, LSW
• Annette Renee Gray
• Douglas Gray
• Eugene Gray II

• Non-emergency Medical Transport (VAN) in Dayton, OH
• Providers in Dayton, OH by specialty
• Non-emergency Medical Transport (VAN) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.