1710428339 NPI number — A2B TRANSPORTATION SERVICES LLC

Table of content: (NPI 1710428339)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710428339 NPI number — A2B TRANSPORTATION SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A2B TRANSPORTATION SERVICES 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:
1710428339
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/15/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3013 RAINBOW DR
Provider Second Line Business Mailing Address:
112-C
Provider Business Mailing Address City Name:
DECATUR
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30034-1677
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-903-4664
Provider Business Mailing Address Fax Number:
404-228-6298

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3013 RAINBOW DR
Provider Second Line Business Practice Location Address:
112-C
Provider Business Practice Location Address City Name:
DECATUR
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30034-1677
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-903-4664
Provider Business Practice Location Address Fax Number:
404-228-6298
Provider Enumeration Date:
03/15/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GRAY
Authorized Official First Name:
ANTHONY
Authorized Official Middle Name:
MELVIN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
404-903-4664

Provider Taxonomy Codes

  • Taxonomy code: 343900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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