Heaven Transport LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

HEAVEN TRANSPORT LLC

Practice address

16440 Stedham Cir Apt 10116440
Dumfries, VA 22025-1560

Phone

(703) 989-0589

NPI assigned

Sep 14, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Yonas Zerai Tewoldemedhin

Title

Ceo

Phone

(703) 989-0589

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600041600000",
    "number": "1073128310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16440 STEDHAM CIR APT 10116440",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220251560",
            "telephone_number": "703-989-0589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16440 STEDHAM CIR APT 10116440",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220251560",
            "telephone_number": "703-989-0589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVEN TRANSPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-09",
        "status": "A",
        "authorized_official_last_name": "TEWOLDEMEDHIN",
        "authorized_official_first_name": "YONAS",
        "authorized_official_middle_name": "ZERAI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "703-989-0589",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46565695604",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "No",
            "affiliation": "N",
            "endpointDescription": "No",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "No",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "No",
            "address_1": "16440 Stedham Cir Apt 101",
            "city": "Dumfries",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220252114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Dumfries, VA
• Providers in Dumfries, VA by specialty
• Non-emergency Medical Transport (VAN) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.