Provider Demographics
NPI:1821644600
Name:EXTRA CAR SERVICE LLC
Entity Type:Organization
Organization Name:EXTRA CAR SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LILIANA
Authorized Official - Middle Name:SOLENNY
Authorized Official - Last Name:VILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-761-4587
Mailing Address - Street 1:1041A CASTLE HILL AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10472-6305
Mailing Address - Country:US
Mailing Address - Phone:347-761-4587
Mailing Address - Fax:
Practice Address - Street 1:1041A CASTLE HILL AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472-6305
Practice Address - Country:US
Practice Address - Phone:347-761-4587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-16
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)