Provider Demographics
NPI:1447630389
Name:LEWIS TRANSPORTATION
Entity type:Organization
Organization Name:LEWIS TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAMONA
Authorized Official - Middle Name:F
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:254-371-0462
Mailing Address - Street 1:123 BRODNAX DR
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:TX
Mailing Address - Zip Code:75951-1500
Mailing Address - Country:US
Mailing Address - Phone:254-371-0462
Mailing Address - Fax:409-202-5099
Practice Address - Street 1:123 BRODNAX DR
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TX
Practice Address - Zip Code:75951-1500
Practice Address - Country:US
Practice Address - Phone:254-371-0462
Practice Address - Fax:409-202-5099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle