Provider Demographics
NPI:1588125678
Name:BEYOND TRANSPORTATION LLC
Entity type:Organization
Organization Name:BEYOND TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EHIMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:EDOKPA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-335-4451
Mailing Address - Street 1:100 CUMMINGS CTR STE 307G
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-6107
Mailing Address - Country:US
Mailing Address - Phone:978-335-4451
Mailing Address - Fax:
Practice Address - Street 1:100 CUMMINGS CTR STE 307G
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6107
Practice Address - Country:US
Practice Address - Phone:978-335-4451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-29
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110095279AMedicaid