Provider Demographics
NPI:1932714557
Name:SAFEWAY TRANSPORTATION LLC
Entity Type:Organization
Organization Name:SAFEWAY TRANSPORTATION LLC
Other - Org Name:SAFEWAY TRANSPORTATION LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:VAUGHN
Authorized Official - Last Name:MUNDY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:336-689-5497
Mailing Address - Street 1:2013 BRIARCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-2428
Mailing Address - Country:US
Mailing Address - Phone:133-668-9549
Mailing Address - Fax:336-656-2982
Practice Address - Street 1:2013 BRIARCLIFF DR
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-2428
Practice Address - Country:US
Practice Address - Phone:336-689-5497
Practice Address - Fax:336-656-2982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-10
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)