Provider Demographics
NPI:1609312941
Name:ABW EXPRESS LLC
Entity Type:Organization
Organization Name:ABW EXPRESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAEMIAN
Authorized Official - Middle Name:TRESANDO
Authorized Official - Last Name:SOUTH
Authorized Official - Suffix:
Authorized Official - Credentials:PROVIDER
Authorized Official - Phone:323-532-1157
Mailing Address - Street 1:13528 LEMOLI AVE
Mailing Address - Street 2:APT 16
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-8724
Mailing Address - Country:US
Mailing Address - Phone:323-532-1157
Mailing Address - Fax:
Practice Address - Street 1:13528 LEMOLI AVE
Practice Address - Street 2:APT 16
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-8724
Practice Address - Country:US
Practice Address - Phone:323-532-1157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi