Provider Demographics
NPI:1427180538
Name:GENERATION INCORPORTATED
Entity Type:Organization
Organization Name:GENERATION INCORPORTATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILBUR
Authorized Official - Middle Name:DWIGHT
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:202-360-2224
Mailing Address - Street 1:2175 FAWN CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-2222
Mailing Address - Country:US
Mailing Address - Phone:202-360-2224
Mailing Address - Fax:240-222-3782
Practice Address - Street 1:2175 FAWN CT
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-2222
Practice Address - Country:US
Practice Address - Phone:202-360-2224
Practice Address - Fax:240-222-3782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC200044343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)