Provider Demographics
NPI:1154862134
Name:BAI VALLEY TRANSPORTATION, LLC
Entity Type:Organization
Organization Name:BAI VALLEY TRANSPORTATION, LLC
Other - Org Name:TAXIWAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ADOLPH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-330-3905
Mailing Address - Street 1:2810 150TH AVE
Mailing Address - Street 2:
Mailing Address - City:EVERLY
Mailing Address - State:IA
Mailing Address - Zip Code:51338-7570
Mailing Address - Country:US
Mailing Address - Phone:712-330-3905
Mailing Address - Fax:
Practice Address - Street 1:2810 150TH AVE
Practice Address - Street 2:
Practice Address - City:EVERLY
Practice Address - State:IA
Practice Address - Zip Code:51338-7570
Practice Address - Country:US
Practice Address - Phone:712-330-3905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-10
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi