Provider Demographics
NPI:1750145017
Name:ME NEM TPT LLC
Entity type:Organization
Organization Name:ME NEM TPT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MESERET
Authorized Official - Middle Name:G
Authorized Official - Last Name:WODAJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-620-9112
Mailing Address - Street 1:6151 EDSALL RD
Mailing Address - Street 2:APT M
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-4184
Mailing Address - Country:US
Mailing Address - Phone:571-620-9112
Mailing Address - Fax:
Practice Address - Street 1:6151 EDSALL RD
Practice Address - Street 2:APT M
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-4184
Practice Address - Country:US
Practice Address - Phone:571-620-9112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)