=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295518009
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LEVI TRANSPORTATIONS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/15/2023
-----------------------------------------------------
Last Update Date | 08/17/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 215 CIRCLE RD APT 12
-----------------------------------------------------
City | MANCHESTER
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03103-3189
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-584-9134
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 215 CIRCLE RD APT 12
-----------------------------------------------------
City | MANCHESTER
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03103-3189
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-584-9134
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER CEO
-----------------------------------------------------
Name | NATHAN ABRAHAM MARTINEZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 603-584-9134
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 342000000X
-----------------------------------------------------
Taxonomy Name | Transportation Network Company
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------