Provider Demographics
NPI:1568113025
Name:WASHITUP LOGISTICS LLC
Entity Type:Organization
Organization Name:WASHITUP LOGISTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTER NURSE
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:S
Authorized Official - Last Name:UPTON
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTER NURSE
Authorized Official - Phone:708-574-0366
Mailing Address - Street 1:15436 INGLESIDE AVE
Mailing Address - Street 2:
Mailing Address - City:DOLTON
Mailing Address - State:IL
Mailing Address - Zip Code:60419-2758
Mailing Address - Country:US
Mailing Address - Phone:708-574-0366
Mailing Address - Fax:
Practice Address - Street 1:15436 INGLESIDE AVE
Practice Address - Street 2:
Practice Address - City:DOLTON
Practice Address - State:IL
Practice Address - Zip Code:60419-2758
Practice Address - Country:US
Practice Address - Phone:708-574-0366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-15
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty