Provider Demographics
NPI:1205602950
Name:AFFINITY TRANSPORTATION LLC
Entity type:Organization
Organization Name:AFFINITY TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:AFAMEFUNA
Authorized Official - Middle Name:A
Authorized Official - Last Name:JASPER-DURUZOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-734-9544
Mailing Address - Street 1:20884 BARKER ST
Mailing Address - Street 2:
Mailing Address - City:LYNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60411-8727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20884 BARKER ST
Practice Address - Street 2:
Practice Address - City:LYNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60411-8727
Practice Address - Country:US
Practice Address - Phone:480-734-9544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)