Provider Demographics
NPI:1205358066
Name:ADWA TRANSPORTATION SERVICES, LLC
Entity type:Organization
Organization Name:ADWA TRANSPORTATION SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SINTAYEHU
Authorized Official - Middle Name:
Authorized Official - Last Name:ABEBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-786-0891
Mailing Address - Street 1:6024 STODDARD CT APT 202
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-5612
Mailing Address - Country:US
Mailing Address - Phone:703-786-0891
Mailing Address - Fax:
Practice Address - Street 1:6024 STODDARD CT APT 202
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22315-5612
Practice Address - Country:US
Practice Address - Phone:703-786-0891
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAT62766405343900000X
VA49D2142823291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)