Organization
SAFEWAY TRANSPORTATION SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANETHER JOHNSON (OWNER)
(601) 528-4563
Entity
Organization
Contact information
Practice address
618 EAST 2ND AVENUE, WIGGINS, MS 39577
(601) 528-4563
Mailing address
618 SECOND AVE E, WIGGINS, MS 39577-2806
(601) 528-4563
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1-601-528-4563
—
MS
Enumeration date
01/06/2022
Last updated
01/06/2022
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