Provider Demographics
NPI:1497421846
Name:MAKE A WAY TRANSIT LLC
Entity Type:Organization
Organization Name:MAKE A WAY TRANSIT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:WANITA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-264-3062
Mailing Address - Street 1:750 E US HIGHWAY 80 STE 200-423
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-8722
Mailing Address - Country:US
Mailing Address - Phone:901-264-3062
Mailing Address - Fax:
Practice Address - Street 1:3829 ANNETTE LN
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38127-4304
Practice Address - Country:US
Practice Address - Phone:901-264-3062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)