Provider Demographics
NPI:1194409607
Name:JORDAN TRANSPORTATION LLC
Entity type:Organization
Organization Name:JORDAN TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGET
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-354-0653
Mailing Address - Street 1:107 CAW CAW HWY
Mailing Address - Street 2:
Mailing Address - City:SAINT MATTHEWS
Mailing Address - State:SC
Mailing Address - Zip Code:29135-7801
Mailing Address - Country:US
Mailing Address - Phone:803-354-0653
Mailing Address - Fax:844-890-6743
Practice Address - Street 1:107 CAW CAW HWY
Practice Address - Street 2:
Practice Address - City:SAINT MATTHEWS
Practice Address - State:SC
Practice Address - Zip Code:29135-7801
Practice Address - Country:US
Practice Address - Phone:803-354-0653
Practice Address - Fax:844-890-6743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)