Provider Demographics
NPI:1841442878
Name:GOD'S WAY TRANSPORTATION
Entity type:Organization
Organization Name:GOD'S WAY TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:FLUELLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-272-2070
Mailing Address - Street 1:PO BOX 27556
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48227-0556
Mailing Address - Country:US
Mailing Address - Phone:313-272-2070
Mailing Address - Fax:313-272-2699
Practice Address - Street 1:15800 FENKELL ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48227-2309
Practice Address - Country:US
Practice Address - Phone:313-272-2070
Practice Address - Fax:313-272-2699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIF445115001704343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)