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General NPI Number Information
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NPI Number | 1750741948
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Entity Type | Organization
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Legal Business Name | MAXWELL'S TRANSIT SERVICE
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Dates
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Enumeration Date | 03/01/2016
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Last Update Date | 03/01/2016
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Provider Practice Location Address
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Address Line | 2541 HIGHWAY 182 W
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City | STARKVILLE
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State | MS
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Zip | 39759-9455
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Country | US
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Telephone | 662-617-9866
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Fax |
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Provider Business Mailing Address
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Address Line | 2541 HIGHWAY 182 W
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City | STARKVILLE
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State | MS
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Zip | 39759-9455
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Country | US
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Telephone | 662-617-9866
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. VIDAL MASHUN MAXWELL I
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Credential |
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Telephone | 662-617-9866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number | 801593435
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License Number State | MS
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