Provider Demographics
NPI:1376088377
Name:AMERICAN WAY TRANSPORTATION
Entity Type:Organization
Organization Name:AMERICAN WAY TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VOLODYMYR
Authorized Official - Middle Name:
Authorized Official - Last Name:FEDOROV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-678-4758
Mailing Address - Street 1:183 LEXINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-1100
Mailing Address - Country:US
Mailing Address - Phone:617-678-4758
Mailing Address - Fax:
Practice Address - Street 1:183 LEXINGTON ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-1100
Practice Address - Country:US
Practice Address - Phone:617-678-4758
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN WAY TRANSPORTATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-12-29
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)