Provider Demographics
NPI:1093122780
Name:TRANSPORT IN PEACE LLC
Entity Type:Organization
Organization Name:TRANSPORT IN PEACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ALEKSANDR
Authorized Official - Middle Name:V
Authorized Official - Last Name:TOKAREV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-325-0107
Mailing Address - Street 1:197 MARIANNA ST
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902-1655
Mailing Address - Country:US
Mailing Address - Phone:978-325-0107
Mailing Address - Fax:
Practice Address - Street 1:197 MARIANNA ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-1655
Practice Address - Country:US
Practice Address - Phone:978-325-0107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)