1083823561 NPI number — FIVESTAR TRANSPORTATION INC

Table of content: (NPI 1083823561)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083823561 NPI number — FIVESTAR TRANSPORTATION INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FIVESTAR 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:
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:
1083823561
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/03/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2548 GALLINI DRIVE
Provider Second Line Business Mailing Address:
49 SOUTH DAY STREET ORANGE, NEW JERSEY 07050
Provider Business Mailing Address City Name:
UNION
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07083
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-673-0266
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
49 S DAY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORANGE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07050-3503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-673-0266
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CUTTINO
Authorized Official First Name:
MARK
Authorized Official Middle Name:
K
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
973-673-0266

Provider Taxonomy Codes

  • Taxonomy code: 343900000X , with the licence number:  5020506 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com