Provider Demographics
NPI:1962880179
Name:AXIS TRANS LLC
Entity type:Organization
Organization Name:AXIS TRANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:718-498-4444
Mailing Address - Street 1:1304 UTICA AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-5912
Mailing Address - Country:US
Mailing Address - Phone:718-498-4444
Mailing Address - Fax:
Practice Address - Street 1:1304 UTICA AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-5912
Practice Address - Country:US
Practice Address - Phone:718-498-4444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)