Provider Demographics
NPI:1043024748
Name:EYOBPDX TRANSPORTATION LLC
Entity type:Organization
Organization Name:EYOBPDX TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EYOB
Authorized Official - Middle Name:BRHANE
Authorized Official - Last Name:MELES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-383-2885
Mailing Address - Street 1:23 N WYGANT ST APT B
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-2863
Mailing Address - Country:US
Mailing Address - Phone:206-383-2885
Mailing Address - Fax:
Practice Address - Street 1:23 N WYGANT ST APT B
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97217-2863
Practice Address - Country:US
Practice Address - Phone:206-383-2885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)