Provider Demographics
NPI:1942705215
Name:GLORY TRANSPORTATION
Entity Type:Organization
Organization Name:GLORY TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:AIYESHA
Authorized Official - Middle Name:CHARMAINE
Authorized Official - Last Name:PENDLETON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-713-6346
Mailing Address - Street 1:122 BARTON ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14611-3814
Mailing Address - Country:US
Mailing Address - Phone:585-713-6346
Mailing Address - Fax:
Practice Address - Street 1:122 BARTON ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14611-3814
Practice Address - Country:US
Practice Address - Phone:585-713-6346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-28
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi