Provider Demographics
NPI:1740974013
Name:BON VOYAGE TRANSPORT
Entity type:Organization
Organization Name:BON VOYAGE TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JERMAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWSOME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-993-1905
Mailing Address - Street 1:2251 WEBB ST APT 201
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48206-3337
Mailing Address - Country:US
Mailing Address - Phone:248-993-6482
Mailing Address - Fax:
Practice Address - Street 1:2251 WEBB ST APT 201
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48206-3337
Practice Address - Country:US
Practice Address - Phone:248-993-6482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle