Provider Demographics
NPI:1770217978
Name:TWAL LOGISTICS LLC
Entity Type:Organization
Organization Name:TWAL LOGISTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BASHEER
Authorized Official - Middle Name:
Authorized Official - Last Name:ALTWAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-389-3892
Mailing Address - Street 1:6712 GREENLAND CHASE BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-9445
Mailing Address - Country:US
Mailing Address - Phone:650-389-3892
Mailing Address - Fax:
Practice Address - Street 1:6747 EDGEWOOD RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-1610
Practice Address - Country:US
Practice Address - Phone:650-389-3892
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-13
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI9798278Medicaid