=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568934982
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NEW ENGLAND TRANSPORT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/24/2018
-----------------------------------------------------
Last Update Date | 12/24/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15 WASHBURN ST
-----------------------------------------------------
City | PROVIDENCE
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02908-4934
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-919-6674
-----------------------------------------------------
Fax | 401-427-0526
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 27224
-----------------------------------------------------
City | PROVIDENCE
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02907-0598
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-919-6674
-----------------------------------------------------
Fax | 401-919-6674
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | SOULEYMANE KABWE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 401-919-6674
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251K00000X
-----------------------------------------------------
Taxonomy Name | Public Health or Welfare Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------