Provider Demographics
NPI:1619438702
Name:JEREMIAH LOGISTICS LLC
Entity Type:Organization
Organization Name:JEREMIAH LOGISTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUHEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MEJIA REYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-209-5596
Mailing Address - Street 1:11639 NW 18TH PL
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34482-7935
Mailing Address - Country:US
Mailing Address - Phone:352-209-5596
Mailing Address - Fax:
Practice Address - Street 1:11639 NW 18TH PL
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34482-7935
Practice Address - Country:US
Practice Address - Phone:352-209-5596
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-29
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)