Provider Demographics
NPI:1578227377
Name:NAZARETH ET TRANSPORTATION COMPANY LLC
Entity Type:Organization
Organization Name:NAZARETH ET TRANSPORTATION COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EBOR
Authorized Official - Middle Name:ABEBE
Authorized Official - Last Name:TEDBABE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-366-1118
Mailing Address - Street 1:3920 FREEPORT PL APT 11
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23233-1264
Mailing Address - Country:US
Mailing Address - Phone:202-867-6677
Mailing Address - Fax:
Practice Address - Street 1:3920 FREEPORT PL APT 11
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233-1264
Practice Address - Country:US
Practice Address - Phone:202-867-6677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)