1649467275 NPI number — ULTIMATE TRANSPORTATION, INC

Table of content: (NPI 1649467275)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649467275 NPI number — ULTIMATE TRANSPORTATION, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ULTIMATE TRANSPORTATION, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
N/A
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649467275
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/27/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6000 STEVENSON AVE STE A
Provider Second Line Business Mailing Address:
6000 STEVENSON AVE STE A
Provider Business Mailing Address City Name:
ALEXANDRIA
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22304-3526
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-988-0279
Provider Business Mailing Address Fax Number:
703-461-3552

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6000 STEVENSON AVE STE A
Provider Second Line Business Practice Location Address:
6000 STEVENSON AVE. SUITE A
Provider Business Practice Location Address City Name:
ALEXANDRIA
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22304-3526
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-988-0279
Provider Business Practice Location Address Fax Number:
703-988-0279
Provider Enumeration Date:
09/27/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
NGUNDAM
Authorized Official First Name:
ADOLF
Authorized Official Middle Name:
N
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
703-988-0279

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  0117004815 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 341600000X , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)