Provider Demographics
NPI:1164085379
Name:JOHNSON SPIVEY AND SPIVEY INC
Entity Type:Organization
Organization Name:JOHNSON SPIVEY AND SPIVEY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAKISHA
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-448-6662
Mailing Address - Street 1:65 ROSEWOOD TER
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-4923
Mailing Address - Country:US
Mailing Address - Phone:585-448-6662
Mailing Address - Fax:
Practice Address - Street 1:65 ROSEWOOD TER
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-4923
Practice Address - Country:US
Practice Address - Phone:585-448-6662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport