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General NPI Number Information
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NPI Number | 1942705215
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Entity Type | Organization
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Legal Business Name | GLORY TRANSPORTATION
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Dates
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Enumeration Date | 03/28/2018
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Last Update Date | 03/28/2018
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Provider Practice Location Address
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Address Line | 122 BARTON ST
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City | ROCHESTER
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State | NY
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Zip | 14611-3814
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Country | US
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Telephone | 585-713-6346
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Fax |
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Provider Business Mailing Address
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Address Line | 122 BARTON ST
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City | ROCHESTER
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State | NY
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Zip | 14611-3814
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Country | US
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Telephone | 585-713-6346
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | AIYESHA CHARMAINE PENDLETON
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Credential |
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Telephone | 585-713-6346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number |
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License Number State |
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