Evergreen Transport;LLC

Primary specialty

Private VehicleTaxonomy code 347C00000X

Legal business name

EVERGREEN TRANSPORT;LLC

Doing business as

Evergreen Transport; LLC

Practice address

680 Amboy Ave
Woodbridge, NJ 07095-3120

Phone

(732) 207-5893

Fax

(732) 777-1449

NPI assigned

Feb 3, 2020

Organization subpart

No

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

Authorized official

Name

Wahid S Shibli

Title

Manager Admin

Phone

(732) 207-5893

Specialties & licenses 1

Addresses

Other names 1

• EVERGREEN TRANSPORT; LLC Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1580688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580688000000",
    "number": "1295366789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 TREEVIEW LN",
            "city": "CLIFFWOOD",
            "state": "NJ",
            "postal_code": "077211268",
            "telephone_number": "732-207-5893",
            "fax_number": "732-777-1449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 AMBOY AVE",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070953120",
            "telephone_number": "732-207-5893",
            "fax_number": "732-777-1449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN TRANSPORT;LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-03",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A",
        "authorized_official_last_name": "SHIBLI",
        "authorized_official_first_name": "WAHID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MANAGER ADMIN",
        "authorized_official_telephone_number": "732-207-5893"
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "WOODBRIDGE",
            "affiliation": "N",
            "endpointDescription": "OFFICE",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8 Treeview Ln",
            "city": "Cliffwood",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "077211268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "EVERGREEN TRANSPORT; LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Private Vehicle in Woodbridge, NJ
• Providers in Woodbridge, NJ by specialty
• Private Vehicle in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.