=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053023663
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JUMA EXPRESS TRANSPORTATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/15/2022
-----------------------------------------------------
Last Update Date | 12/15/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18394 BLYTHE WAY
-----------------------------------------------------
City | BLYTHE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92225-2262
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-349-2449
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 18394 BLYTHE WAY
-----------------------------------------------------
City | BLYTHE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92225-2262
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-349-2449
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/CEO
-----------------------------------------------------
Name | SOFIA SHUA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 951-349-2449
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 342000000X
-----------------------------------------------------
Taxonomy Name | Transportation Network Company
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------