Healthcare Provider Details

I. General information

NPI: 1033034269
Provider Name (Legal Business Name): WILLOW CORE LOGISTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 N ALLEN ST
ALBANY NY
12206-1713
US

IV. Provider business mailing address

618 3RD ST
ALBANY NY
12206-2254
US

V. Phone/Fax

Practice location:
  • Phone: 386-689-3257
  • Fax:
Mailing address:
  • Phone: 386-689-3257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: EDWIN ENGUR
Title or Position: MANAGING MEMBER
Credential:
Phone: 386-689-3257