Provider Demographics
NPI:1912582826
Name:WILLIAMSBURG TRANSPORTATION LLC
Entity Type:Organization
Organization Name:WILLIAMSBURG TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ESUBALEW
Authorized Official - Middle Name:TADESSE
Authorized Official - Last Name:AMERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-707-6356
Mailing Address - Street 1:5403 ROBINSON LN
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-2920
Mailing Address - Country:US
Mailing Address - Phone:757-707-6356
Mailing Address - Fax:757-299-9500
Practice Address - Street 1:4391 IRONBOUND RD STE E
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-2659
Practice Address - Country:US
Practice Address - Phone:757-707-6356
Practice Address - Fax:757-299-9500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-11
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)