Provider Demographics
NPI:1649002916
Name:INOVA TRANSPORTATION LLC
Entity type:Organization
Organization Name:INOVA TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BEZAWIT
Authorized Official - Middle Name:T
Authorized Official - Last Name:TASEW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-524-8549
Mailing Address - Street 1:2478 MASONS FERRY DR APT 302
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-4513
Mailing Address - Country:US
Mailing Address - Phone:800-639-0141
Mailing Address - Fax:
Practice Address - Street 1:2478 MASONS FERRY DR APT 302
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-4513
Practice Address - Country:US
Practice Address - Phone:800-639-0141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)