Organization
AMAZING GRACE TRANSPORTATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AGUSTUS AMASHA (ADMIN/OWNER)
(518) 250-4664
Entity
Organization
Contact information
Practice address
1575 STATE ST, SCHENECTADY, NY 12304-1521
(518) 250-4664
(518) 250-4665
Mailing address
1575 STATE ST, SCHENECTADY, NY 12304-1521
(518) 250-4664
(518) 250-4665
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
38057
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03280926
—
NY
Enumeration date
06/09/2016
Last updated
06/09/2016
Update your record
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