Provider Demographics
NPI:1063934545
Name:ROJHALEX ENTERPRISER LLC
Entity type:Organization
Organization Name:ROJHALEX ENTERPRISER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-899-9918
Mailing Address - Street 1:3158 CEDAR GROVE DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-1708
Mailing Address - Country:US
Mailing Address - Phone:703-899-9918
Mailing Address - Fax:703-563-6096
Practice Address - Street 1:3158 CEDAR GROVE DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-1708
Practice Address - Country:US
Practice Address - Phone:703-899-9918
Practice Address - Fax:703-563-6096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-17
Last Update Date:2017-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA224343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)