Provider Demographics
NPI:1912547910
Name:SHADAI TRANSPORTATION LLC
Entity Type:Organization
Organization Name:SHADAI TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:VIOLA
Authorized Official - Last Name:SOSU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-303-0272
Mailing Address - Street 1:3507 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-4310
Mailing Address - Country:US
Mailing Address - Phone:717-303-0272
Mailing Address - Fax:717-303-0273
Practice Address - Street 1:3507 MARKET ST
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-4310
Practice Address - Country:US
Practice Address - Phone:717-303-0272
Practice Address - Fax:717-303-0273
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHADAI HEALTHCARE SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)