Provider Demographics
NPI:1376254946
Name:WALA TRANSPORT LLC
Entity Type:Organization
Organization Name:WALA TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAUNDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-263-3008
Mailing Address - Street 1:5605 CHARLES DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-3717
Mailing Address - Country:US
Mailing Address - Phone:813-368-3610
Mailing Address - Fax:
Practice Address - Street 1:5605 CHARLES DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-3717
Practice Address - Country:US
Practice Address - Phone:813-368-3610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)