Provider Demographics
NPI:1891182135
Name:YODIT KASSA
Entity Type:Organization
Organization Name:YODIT KASSA
Other - Org Name:YAA TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YODIT
Authorized Official - Middle Name:
Authorized Official - Last Name:KASSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-297-1487
Mailing Address - Street 1:2958 DONNELL DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-5709
Mailing Address - Country:US
Mailing Address - Phone:512-297-1487
Mailing Address - Fax:512-671-6959
Practice Address - Street 1:2958 DONNELL DR
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-5709
Practice Address - Country:US
Practice Address - Phone:512-297-1487
Practice Address - Fax:512-671-6959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)