Provider Demographics
NPI:1336865732
Name:WESTFIELD 1 MINORITY BUSINESS LLC
Entity Type:Organization
Organization Name:WESTFIELD 1 MINORITY BUSINESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BAIBAI
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-288-9655
Mailing Address - Street 1:6002 ASHBY HEIGHTS CIR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-3804
Mailing Address - Country:US
Mailing Address - Phone:703-288-9655
Mailing Address - Fax:
Practice Address - Street 1:6002 ASHBY HEIGHTS CIR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22315-3804
Practice Address - Country:US
Practice Address - Phone:703-288-9655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAIM1439OtherDMV OPERATING AUTHORITY CERTIFICATE