Provider Demographics
NPI:1508324591
Name:ON TRACK TRANSPORTATION LLC
Entity Type:Organization
Organization Name:ON TRACK TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YEMESERACH
Authorized Official - Middle Name:
Authorized Official - Last Name:DESSALEGN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-415-1789
Mailing Address - Street 1:8801 DENA DR
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23229-4610
Mailing Address - Country:US
Mailing Address - Phone:804-500-0484
Mailing Address - Fax:804-500-0483
Practice Address - Street 1:9001 PATTERSON AVE APT 25
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-6183
Practice Address - Country:US
Practice Address - Phone:804-500-0484
Practice Address - Fax:804-500-0483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-08
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No342000000XTransportation ServicesTransportation Network Company
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA622OtherOPERATING AUTHORITY
VA780OtherNONE EMERGENCY MEDICAL TRANSPORTATION