Healthcare Provider Details

I. General information

NPI: 1053513895
Provider Name (Legal Business Name): FOUR J'S TRANSPORTATION INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 09/14/2020
Certification Date: 09/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 PEARL ST STE A
PORT CHESTER NY
10573-7615
US

IV. Provider business mailing address

PO BOX 107
PORT CHESTER NY
10573-0107
US

V. Phone/Fax

Practice location:
  • Phone: 914-937-5823
  • Fax: 203-748-3725
Mailing address:
  • Phone: 914-937-5823
  • Fax: 203-748-3725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number01937993
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. POLLY HERRING
Title or Position: OFFICE MANAGER
Credential:
Phone: 914-937-5823