1871023523 NPI number — METROWAY TRANSPORTATION LLC

Table of content: (NPI 1871023523)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871023523 NPI number — METROWAY TRANSPORTATION LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
METROWAY TRANSPORTATION LLC
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:
Provider Other Organization Name Type Code:
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:
1871023523
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2200 N CANTON CENTER RD STE 200A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CANTON
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48187-5038
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-892-2901
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2200 N. CANTON CENTER
Provider Second Line Business Practice Location Address:
STE. 200A
Provider Business Practice Location Address City Name:
CANTON
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48187
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-892-2901
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/15/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MARKS
Authorized Official First Name:
DONNA
Authorized Official Middle Name:
JEAN
Authorized Official Title or Position:
CFO/CO- OWNER
Authorized Official Telephone Number:
313-587-2679

Provider Taxonomy Codes

  • Taxonomy code: 343900000X , with the licence number:  L2622 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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