Provider Demographics
NPI:1821264821
Name:EDWARDS MESSAGING AND TRANSPORATION INC
Entity Type:Organization
Organization Name:EDWARDS MESSAGING AND TRANSPORATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHERITA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-739-2077
Mailing Address - Street 1:212 VERNON DR
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-2423
Mailing Address - Country:US
Mailing Address - Phone:630-739-2077
Mailing Address - Fax:630-739-2077
Practice Address - Street 1:212 VERNON DR
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-2423
Practice Address - Country:US
Practice Address - Phone:630-739-2077
Practice Address - Fax:630-739-2077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid