Provider Demographics
NPI:1740779123
Name:LION OF JUDAH MASS TRANSIT LLC
Entity Type:Organization
Organization Name:LION OF JUDAH MASS TRANSIT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BLAISE
Authorized Official - Middle Name:OGECHI
Authorized Official - Last Name:OSUJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-342-1156
Mailing Address - Street 1:6811 KENILWORTH AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1318
Mailing Address - Country:US
Mailing Address - Phone:240-342-1156
Mailing Address - Fax:
Practice Address - Street 1:6811 KENILWORTH AVE STE 500
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1318
Practice Address - Country:US
Practice Address - Phone:240-342-1156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-01
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3145343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)