Provider Demographics
NPI:1114570231
Name:FRONTIER TRANSPORT LLC
Entity Type:Organization
Organization Name:FRONTIER TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EJIKEME
Authorized Official - Middle Name:EMEKA
Authorized Official - Last Name:NWOSU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-337-7696
Mailing Address - Street 1:6415 KILMER ST
Mailing Address - Street 2:
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1309
Mailing Address - Country:US
Mailing Address - Phone:301-337-7696
Mailing Address - Fax:
Practice Address - Street 1:6415 KILMER ST
Practice Address - Street 2:
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1309
Practice Address - Country:US
Practice Address - Phone:301-337-7696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)