Provider Demographics
NPI:1447944558
Name:MIDWAY TRANSPORTATION
Entity type:Organization
Organization Name:MIDWAY TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:VALARIE
Authorized Official - Middle Name:LAROSE
Authorized Official - Last Name:OWENS-BARTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-878-2116
Mailing Address - Street 1:(968 MOORER RD
Mailing Address - Street 2:
Mailing Address - City:ST. MATTHEWS
Mailing Address - State:SC
Mailing Address - Zip Code:29135
Mailing Address - Country:US
Mailing Address - Phone:803-878-2116
Mailing Address - Fax:
Practice Address - Street 1:970 MOORER RD
Practice Address - Street 2:
Practice Address - City:ST. MATTHEWS
Practice Address - State:SC
Practice Address - Zip Code:29135
Practice Address - Country:US
Practice Address - Phone:803-878-2116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)