Provider Demographics
NPI:1134697394
Name:STEVENS TRANSPORTATION GROUP, LLC
Entity Type:Organization
Organization Name:STEVENS TRANSPORTATION GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:L
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:301-795-0200
Mailing Address - Street 1:PO BOX 2436
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20891-2436
Mailing Address - Country:US
Mailing Address - Phone:301-795-0200
Mailing Address - Fax:240-669-7664
Practice Address - Street 1:11902 PARKLAWN PL APT 104
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-5207
Practice Address - Country:US
Practice Address - Phone:202-779-2830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-06
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)