Provider Demographics
NPI:1407307366
Name:ECHELON TRANSPORT INC
Entity Type:Organization
Organization Name:ECHELON TRANSPORT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NAHSHON
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-683-9879
Mailing Address - Street 1:9470 SILVER BUTTONWOOD ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-5657
Mailing Address - Country:US
Mailing Address - Phone:407-683-9879
Mailing Address - Fax:407-367-5717
Practice Address - Street 1:9276 NORTHLAKE PKWY
Practice Address - Street 2:SUITE 115
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-5727
Practice Address - Country:US
Practice Address - Phone:407-683-9879
Practice Address - Fax:407-367-5717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBUS-0049547347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle