Provider Demographics
NPI:1992345532
Name:ROADYS MED TRANSPORTATION LLC
Entity type:Organization
Organization Name:ROADYS MED TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEPARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-527-5491
Mailing Address - Street 1:PO BOX 184
Mailing Address - Street 2:
Mailing Address - City:MOHAWK
Mailing Address - State:NY
Mailing Address - Zip Code:13407-0184
Mailing Address - Country:US
Mailing Address - Phone:315-527-5491
Mailing Address - Fax:315-219-5929
Practice Address - Street 1:6 W MAIN ST APT 3
Practice Address - Street 2:
Practice Address - City:MOHAWK
Practice Address - State:NY
Practice Address - Zip Code:13407-1068
Practice Address - Country:US
Practice Address - Phone:315-527-5491
Practice Address - Fax:315-219-5929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-12
Last Update Date:2020-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)