=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124607619
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LAMA TRANSPORTATION, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/03/2021
-----------------------------------------------------
Last Update Date | 04/03/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6401 GREYHAVEN DR
-----------------------------------------------------
City | NORTH CHESTERFIELD
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23234-5713
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-259-5973
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6401 GREYHAVEN DR
-----------------------------------------------------
City | NORTH CHESTERFIELD
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23234-5713
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-259-5973
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | NYDEYE PIPKINS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 804-665-7699
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 347E00000X
-----------------------------------------------------
Taxonomy Name | Transportation Broker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------