Provider Demographics
NPI:1093091852
Name:GALY TRANSPORTATION LLC
Entity Type:Organization
Organization Name:GALY TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:RECA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-202-8164
Mailing Address - Street 1:1 ABBOTSFORD ST
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02121-1409
Mailing Address - Country:US
Mailing Address - Phone:617-202-8164
Mailing Address - Fax:617-445-7601
Practice Address - Street 1:40 CEDRIC ST.
Practice Address - Street 2:
Practice Address - City:ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02119
Practice Address - Country:US
Practice Address - Phone:617-202-8164
Practice Address - Fax:617-445-7601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAS56764111343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)