Provider Demographics
NPI:1982170437
Name:LIBERTY TRANSIT INC
Entity type:Organization
Organization Name:LIBERTY TRANSIT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAJNI
Authorized Official - Middle Name:
Authorized Official - Last Name:BALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-758-4095
Mailing Address - Street 1:PO BOX 711
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-0621
Mailing Address - Country:US
Mailing Address - Phone:707-643-3333
Mailing Address - Fax:707-643-3372
Practice Address - Street 1:289 5TH ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-7209
Practice Address - Country:US
Practice Address - Phone:707-643-3333
Practice Address - Fax:707-643-3372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-22
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)