Provider Demographics
NPI:1619660156
Name:1089 LLC
Entity Type:Organization
Organization Name:1089 LLC
Other - Org Name:E.T.ONE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YEZIHALEM
Authorized Official - Middle Name:S
Authorized Official - Last Name:KEBEW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-499-6848
Mailing Address - Street 1:5565 CAITHNESS CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032-3835
Mailing Address - Country:US
Mailing Address - Phone:703-499-6848
Mailing Address - Fax:
Practice Address - Street 1:5565 CAITHNESS CT
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22032-3835
Practice Address - Country:US
Practice Address - Phone:703-499-6848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-31
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker