Provider Demographics
NPI:1316306095
Name:CITYWIDE TRANSPORTATION LLC
Entity type:Organization
Organization Name:CITYWIDE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LASHAWNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GHOLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-732-0659
Mailing Address - Street 1:1851 FORT MAHONE ST
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23805-2761
Mailing Address - Country:US
Mailing Address - Phone:804-732-0659
Mailing Address - Fax:804-732-0684
Practice Address - Street 1:1851 FORT MAHONE ST
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805-2761
Practice Address - Country:US
Practice Address - Phone:804-732-0659
Practice Address - Fax:804-732-0684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-23
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA268343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)