Provider Demographics
NPI:1912278748
Name:A CLASS 1-S TRANSPORTATION CORP.
Entity Type:Organization
Organization Name:A CLASS 1-S TRANSPORTATION CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROLAND
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:845-381-1337
Mailing Address - Street 1:56 MONRO ST
Mailing Address - Street 2:
Mailing Address - City:WALDEN
Mailing Address - State:NY
Mailing Address - Zip Code:12586-2110
Mailing Address - Country:US
Mailing Address - Phone:845-381-1337
Mailing Address - Fax:888-740-6885
Practice Address - Street 1:2 MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-6229
Practice Address - Country:US
Practice Address - Phone:845-381-1337
Practice Address - Fax:888-740-6885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY12970LV343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02932929Medicaid