Jordan River Inc

Primary specialty

Transportation BrokerTaxonomy code 347E00000X

Legal business name

JORDAN RIVER INC

Practice address

4110 St Charles Bay
San Antonio, TX 78229-2085

Phone

(210) 719-2853

NPI assigned

Nov 2, 2017

Organization subpart

No

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

Authorized official

Name

Aiman Ismail Awadallah

Title

President

Phone

(210) 719-2853

Specialties & licenses 1

Addresses

Other names 1

• GREEN LINE MEDICAL TRANSPORTATION Doing business as

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

{
    "created_epoch": "1509580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509580800000",
    "number": "1154833945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 ST CHARLES BAY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782292085",
            "telephone_number": "210-719-2853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 ST CHARLES BAY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782292085",
            "telephone_number": "210-719-2853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORDAN RIVER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-02",
        "last_updated": "2017-11-02",
        "status": "A",
        "authorized_official_last_name": "AWADALLAH",
        "authorized_official_first_name": "AIMAN",
        "authorized_official_middle_name": "ISMAIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-719-2853"
    },
    "taxonomies": [
        {
            "code": "347E00000X",
            "taxonomy_group": "",
            "desc": "Transportation Broker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GREEN LINE MEDICAL TRANSPORTATION",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Catherine Joo, OD
• Michelle Heeryung Joo, OD
• Deepthi Joolukuntla
• Jessica Joplin, SLP
• Jordan Oak Surgery Assist, PLLC
• Victoria Rosetta Jordan Spicer, LPC
• Judy Sharon Jordan Thomas, MD
• Ashanti Jordan
• Ashley Danielle Jordan
• Corinne Nicole Jordan, D.O.

• Transportation Broker in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Transportation Broker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2017; 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.