Provider Demographics
NPI:1619404985
Name:GOING PLACES TRANSPORTATION AND VARIETY, INC
Entity Type:Organization
Organization Name:GOING PLACES TRANSPORTATION AND VARIETY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:WEATHERLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-395-2436
Mailing Address - Street 1:7662 HAYLAGE CIR
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-8450
Mailing Address - Country:US
Mailing Address - Phone:315-395-2436
Mailing Address - Fax:315-635-1659
Practice Address - Street 1:7662 HAYLAGE CIR
Practice Address - Street 2:
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027-8450
Practice Address - Country:US
Practice Address - Phone:315-395-2436
Practice Address - Fax:315-635-1659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03420591Medicaid