Provider Demographics
NPI:1982466355
Name:SILVER TRANSPORTATION LLC
Entity Type:Organization
Organization Name:SILVER TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DRIVER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAWITE
Authorized Official - Middle Name:WORKU
Authorized Official - Last Name:GEBREKERSTOS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:612-516-9799
Mailing Address - Street 1:1358 MAYNARD DR E APT 260
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-2995
Mailing Address - Country:US
Mailing Address - Phone:612-703-6683
Mailing Address - Fax:
Practice Address - Street 1:1358 MAYNARD DR E APT 260
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-2995
Practice Address - Country:US
Practice Address - Phone:612-703-6683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)