Provider Demographics
NPI:1245752823
Name:POWERS DISTRIBUTION LLC
Entity Type:Organization
Organization Name:POWERS DISTRIBUTION LLC
Other - Org Name:POWERS TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARITZA
Authorized Official - Middle Name:V
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-402-1864
Mailing Address - Street 1:2109 PATRICK ST
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-2532
Mailing Address - Country:US
Mailing Address - Phone:571-402-1864
Mailing Address - Fax:571-364-7398
Practice Address - Street 1:2109 PATRICK ST
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-2532
Practice Address - Country:US
Practice Address - Phone:571-402-1864
Practice Address - Fax:571-364-7398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)