Provider Demographics
NPI:1235961426
Name:EBEN-EZER DELIVERY & TRANSPORTATION LLC
Entity type:Organization
Organization Name:EBEN-EZER DELIVERY & TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARALUZ
Authorized Official - Middle Name:
Authorized Official - Last Name:LARA PINALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-799-0035
Mailing Address - Street 1:134 FLUSHING AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-1450
Mailing Address - Country:US
Mailing Address - Phone:901-799-0035
Mailing Address - Fax:
Practice Address - Street 1:134 FLUSHING AVE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-1450
Practice Address - Country:US
Practice Address - Phone:901-799-0035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi