Provider Demographics
NPI:1508349283
Name:LJ TRANSPORTATION SERVICE
Entity Type:Organization
Organization Name:LJ TRANSPORTATION SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:LAWRENCE M JACKSON
Authorized Official - Phone:716-424-5743
Mailing Address - Street 1:123 SOBIESKI ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14212
Mailing Address - Country:US
Mailing Address - Phone:716-424-5743
Mailing Address - Fax:716-833-1359
Practice Address - Street 1:123 SOBIESKI ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14212
Practice Address - Country:US
Practice Address - Phone:716-424-5743
Practice Address - Fax:716-833-1359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi