Provider Demographics
NPI:1437483955
Name:HEAVENLY TRANSPORTATION
Entity Type:Organization
Organization Name:HEAVENLY TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JULIUS
Authorized Official - Middle Name:J
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-433-9416
Mailing Address - Street 1:1346 W COLONY DR
Mailing Address - Street 2:
Mailing Address - City:CRETE
Mailing Address - State:IL
Mailing Address - Zip Code:60417-2657
Mailing Address - Country:US
Mailing Address - Phone:773-433-9416
Mailing Address - Fax:
Practice Address - Street 1:1346 W COLONY DR
Practice Address - Street 2:
Practice Address - City:CRETE
Practice Address - State:IL
Practice Address - Zip Code:60417-2657
Practice Address - Country:US
Practice Address - Phone:773-433-9416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle