1588896856 NPI number — LACEY COURIER AND TRANSPORTATION CO, INC

Table of content: (NPI 1588896856)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588896856 NPI number — LACEY COURIER AND TRANSPORTATION CO, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LACEY COURIER AND TRANSPORTATION CO, 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:
6
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:
1588896856
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/07/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 169
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORKED RIVER
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08731-0169
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-693-2939
Provider Business Mailing Address Fax Number:
609-693-9620

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
133 S MAIN ST
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
FORKED RIVER
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08731-3624
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-693-2939
Provider Business Practice Location Address Fax Number:
609-693-9260
Provider Enumeration Date:
08/19/2009

Additional Information

Authorized Official

Authorized Official Last Name:
MCELWEE
Authorized Official First Name:
JEFFREY
Authorized Official Middle Name:
C
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
609-693-2939

Provider Taxonomy Codes

  • Taxonomy code: 344600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 344600000X . This is a "NPPES" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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