=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689229320
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MY WAY TRANSPORTATION, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/08/2019
-----------------------------------------------------
Last Update Date | 08/08/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 79 KRON ST
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14619-2035
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-414-7935
-----------------------------------------------------
Fax | 585-355-4719
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 79 KRON ST
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14619-2035
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-414-7935
-----------------------------------------------------
Fax | 585-355-4719
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. LEIGHTON WILLIAMS
-----------------------------------------------------
Credential | LIVERY SERVICE
-----------------------------------------------------
Telephone | 585-414-7935
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 344600000X
-----------------------------------------------------
Taxonomy Name | Taxi
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------