Provider Demographics
NPI:1821761990
Name:CHPH TRANSPORTATION
Entity Type:Organization
Organization Name:CHPH TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/ OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:IKISHIA
Authorized Official - Middle Name:NATAYE
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:267-439-0966
Mailing Address - Street 1:625 E GIRARD AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19125-3400
Mailing Address - Country:US
Mailing Address - Phone:267-439-0966
Mailing Address - Fax:215-425-4400
Practice Address - Street 1:625 E GIRARD AVE APT 1
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19125-3400
Practice Address - Country:US
Practice Address - Phone:267-439-0966
Practice Address - Fax:215-425-4400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No332U00000XSuppliersHome Delivered Meals
No342000000XTransportation ServicesTransportation Network Company
No347C00000XTransportation ServicesPrivate Vehicle