Provider Demographics
NPI:1245454792
Name:MINUTEMAN TRANSPORTATION
Entity type:Organization
Organization Name:MINUTEMAN TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:AYENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-585-5830
Mailing Address - Street 1:9208 HONEY CREEPER CT
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-3326
Mailing Address - Country:US
Mailing Address - Phone:703-459-0922
Mailing Address - Fax:703-992-0234
Practice Address - Street 1:9208 HONEY CREEPER CT
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-3326
Practice Address - Country:US
Practice Address - Phone:703-459-0922
Practice Address - Fax:703-992-0234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC4823416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC027069700Medicaid