Provider Demographics
NPI:1104655836
Name:STATION ONE TRANSPORTATION SERVICES
Entity type:Organization
Organization Name:STATION ONE TRANSPORTATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FATMATA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-308-2109
Mailing Address - Street 1:309 W ELM ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-4260
Mailing Address - Country:US
Mailing Address - Phone:617-308-2109
Mailing Address - Fax:
Practice Address - Street 1:309 W ELM ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-4260
Practice Address - Country:US
Practice Address - Phone:617-308-2109
Practice Address - Fax:800-405-1607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)