Provider Demographics
NPI:1609221431
Name:PAUL WALLACE MANAGEMENT INC
Entity Type:Organization
Organization Name:PAUL WALLACE MANAGEMENT INC
Other - Org Name:SPRINGFIELD YELLOW CAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:MESHESHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-477-5548
Mailing Address - Street 1:7956 TWIST LN
Mailing Address - Street 2:F
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22153-2823
Mailing Address - Country:US
Mailing Address - Phone:703-451-8062
Mailing Address - Fax:703-569-4127
Practice Address - Street 1:7956 TWIST LN
Practice Address - Street 2:F
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22153-2823
Practice Address - Country:US
Practice Address - Phone:703-451-8062
Practice Address - Fax:703-569-4127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-29
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA10220344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi