Provider Demographics
NPI:1942923222
Name:JORDAN TRANSPORTATION LLC
Entity Type:Organization
Organization Name:JORDAN TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YESENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PINA ROSADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-658-8375
Mailing Address - Street 1:1713 TREE DUCK CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-5941
Mailing Address - Country:US
Mailing Address - Phone:757-658-8375
Mailing Address - Fax:
Practice Address - Street 1:1713 TREE DUCK CT
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-5941
Practice Address - Country:US
Practice Address - Phone:757-658-8375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)