Provider Demographics
NPI:1528381662
Name:MTS TRANSPORTATION INC
Entity Type:Organization
Organization Name:MTS TRANSPORTATION INC
Other - Org Name:MTS TRANSPORTATION INC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MINILIK
Authorized Official - Middle Name:
Authorized Official - Last Name:TESSEMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-652-0816
Mailing Address - Street 1:101 S WHITING ST STE 207A
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-3424
Mailing Address - Country:US
Mailing Address - Phone:703-652-0816
Mailing Address - Fax:
Practice Address - Street 1:101 S WHITING ST STE 207A
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-3424
Practice Address - Country:US
Practice Address - Phone:703-652-0816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-03
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC16893416L0300X, 343800000X, 343900000X, 347B00000X, 347E00000X
VA262343800000X, 343900000X, 347C00000X
VA774347B00000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347B00000XTransportation ServicesBus
No3416L0300XTransportation ServicesAmbulanceLand Transport
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No347E00000XTransportation ServicesTransportation Broker
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC1689OtherW.M.A.T.C
262OtherDMV
DC1689OtherW.M.A.T.C