Provider Demographics
NPI:1811530769
Name:SAFEWAY TRANSPORTATION SERVICES CORP
Entity type:Organization
Organization Name:SAFEWAY TRANSPORTATION SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUCKY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAHOTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-599-1085
Mailing Address - Street 1:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-0658
Mailing Address - Country:US
Mailing Address - Phone:847-599-1085
Mailing Address - Fax:
Practice Address - Street 1:550 N GREEN BAY RD STE 1
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-3183
Practice Address - Country:US
Practice Address - Phone:847-599-1085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty