Provider Demographics
NPI:1588948830
Name:ADELLA TRANSPORTATION LLC
Entity type:Organization
Organization Name:ADELLA TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EUCLYSN
Authorized Official - Middle Name:WELLESLEY
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-434-6672
Mailing Address - Street 1:437 HOMESTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10553-1912
Mailing Address - Country:US
Mailing Address - Phone:914-434-6672
Mailing Address - Fax:
Practice Address - Street 1:437 HOMSTEAD AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10553-1912
Practice Address - Country:US
Practice Address - Phone:914-434-6672
Practice Address - Fax:914-662-0538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)