Provider Demographics
NPI:1598387326
Name:MEDWAY TRANSPORTATION LLC
Entity Type:Organization
Organization Name:MEDWAY TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-721-4669
Mailing Address - Street 1:6613 FAWN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-4847
Mailing Address - Country:US
Mailing Address - Phone:619-721-4669
Mailing Address - Fax:
Practice Address - Street 1:6613 FAWN VIEW DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-4847
Practice Address - Country:US
Practice Address - Phone:619-721-4669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDWAY TRANSPORTATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty