Provider Demographics
NPI:1942729504
Name:BISMARK TRANSPORTATION SERVICE LLC
Entity Type:Organization
Organization Name:BISMARK TRANSPORTATION SERVICE LLC
Other - Org Name:BISMARK TRANSPORTATION SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BISMARK
Authorized Official - Middle Name:
Authorized Official - Last Name:ADU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-343-8575
Mailing Address - Street 1:12341 WOODLAWN CT
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-1927
Mailing Address - Country:US
Mailing Address - Phone:571-343-8575
Mailing Address - Fax:703-494-8575
Practice Address - Street 1:12341 WOODLAWN COURT
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192
Practice Address - Country:US
Practice Address - Phone:571-343-8575
Practice Address - Fax:703-494-8575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)