Provider Demographics
NPI:1487141610
Name:AVON TRANSPORTATION LLC
Entity type:Organization
Organization Name:AVON TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:CARSWELL
Authorized Official - Last Name:JAOWI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-703-2333
Mailing Address - Street 1:1265 SLATER RD
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06053
Mailing Address - Country:US
Mailing Address - Phone:860-294-6667
Mailing Address - Fax:
Practice Address - Street 1:1265 SLATER RD
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06053
Practice Address - Country:US
Practice Address - Phone:860-294-6667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-13
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT172A00000X
CTCTDOT3366344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes344600000XTransportation ServicesTaxi
No172A00000XOther Service ProvidersDriverGroup - Single Specialty