Basic Information
Provider Information
NPI: 1750593752
EntityType: 2
ReplacementNPI:  
OrganizationName: EDS TRANSPORTATION
LastName:  
FirstName:  
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Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: 71 OMEGA DR BLDG D
Address2:  
City: NEWARK
State: DE
PostalCode: 19713
CountryCode: US
TelephoneNumber: 3022833300
FaxNumber:  
Practice Location
Address1: 118 SANDY BRAE DR
Address2:  
City: NEWARK
State: DE
PostalCode: 19713
CountryCode: US
TelephoneNumber: 3024541821
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/04/2007
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
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NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: MACCHIONE
AuthorizedOfficialFirstName: EDDIE
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 3024541821
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
341600000X1999209539DEY Transportation ServicesAmbulance 

No ID Information.


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