Healthcare Provider Details

I. General information

NPI: 1679601108
Provider Name (Legal Business Name): BUSH FACTOR, TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 04/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1274 BARNABY TERRANCE S.E.
WASHINGTON DC
20032
US

IV. Provider business mailing address

1274 BARNABY TERRANCE S.E.
WASHINGTON DC
20032
US

V. Phone/Fax

Practice location:
  • Phone: 202-249-1427
  • Fax: 202-561-8859
Mailing address:
  • Phone: 202-249-1427
  • Fax: 202-561-8859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number57994XXXX110404
License Number StateDC

VIII. Authorized Official

Name: MR. ALMUS DEMETRIUS BUSH SR.
Title or Position: C.E.O.
Credential:
Phone: 202-249-1427