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General NPI Number Information
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NPI Number | 1205602950
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Entity Type | Organization
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Legal Business Name | AFFINITY TRANSPORTATION LLC
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Dates
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Enumeration Date | 12/04/2023
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Last Update Date | 12/04/2023
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Provider Practice Location Address
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Address Line | 20884 BARKER ST
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City | LYNWOOD
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State | IL
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Zip | 60411-8727
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Country | US
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Telephone | 480-734-9544
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Fax |
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Provider Business Mailing Address
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Address Line | 20884 BARKER ST
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City | LYNWOOD
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State | IL
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Zip | 60411-8727
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MR. AFAMEFUNA A JASPER-DURUZOR
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Credential |
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Telephone | 480-734-9544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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