Provider Demographics
NPI:1073076303
Name:SAFEWAY TRANSIT COMPANY
Entity Type:Organization
Organization Name:SAFEWAY TRANSIT COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-515-2136
Mailing Address - Street 1:2045 ARBOR CIR W APT 207
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-3415
Mailing Address - Country:US
Mailing Address - Phone:517-515-2136
Mailing Address - Fax:
Practice Address - Street 1:2045 ARBOR CIR W APT 207
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-3415
Practice Address - Country:US
Practice Address - Phone:517-515-2136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI8505157Medicaid