Provider Demographics
NPI:1154070043
Name:CONAWAY MOBILITY SERVICE LLC
Entity Type:Organization
Organization Name:CONAWAY MOBILITY SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DRIVER
Authorized Official - Prefix:
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:RASHAD
Authorized Official - Last Name:CONAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-393-4220
Mailing Address - Street 1:11470 BROOK MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-5322
Mailing Address - Country:US
Mailing Address - Phone:346-393-4220
Mailing Address - Fax:
Practice Address - Street 1:11470 BROOK MEADOW DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-5322
Practice Address - Country:US
Practice Address - Phone:346-393-4220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-20
Last Update Date:2022-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)