Provider Demographics
NPI:1336671775
Name:ON TIME SAFE TRANSPORT LLC
Entity Type:Organization
Organization Name:ON TIME SAFE TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PA BRIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:KARGBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-432-3558
Mailing Address - Street 1:12306 SEA PEARL CT
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-2848
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12306 SEA PEARL CT
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-2848
Practice Address - Country:US
Practice Address - Phone:240-432-3558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-03
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDK621676080964343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD=========OtherEMPLOYER IDENTIFICATION NUMBER