Provider Demographics
NPI:1811416415
Name:EXPRESS TRANSPORTATION, LLC
Entity Type:Organization
Organization Name:EXPRESS TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:N
Authorized Official - Last Name:RAZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-320-3381
Mailing Address - Street 1:6561 EDSALL RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22151-4414
Mailing Address - Country:US
Mailing Address - Phone:571-320-3381
Mailing Address - Fax:
Practice Address - Street 1:6561 EDSALL RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22151-4414
Practice Address - Country:US
Practice Address - Phone:571-320-3381
Practice Address - Fax:703-813-6115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-14
Last Update Date:2017-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1753996343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)