Safeway Transportation Service LLC

Primary specialty

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

Legal business name

SAFEWAY TRANSPORTATION SERVICE LLC

Practice address

618 East 2ND Avenue
Wiggins, MS 39577

Phone

(601) 528-4563

NPI assigned

Jan 6, 2022

Organization subpart

No

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

Authorized official

Name

Sanether JohnsonNPI 1396410577

Title

Owner

Phone

(601) 528-4563

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sanether Johnson

  • Non-emergency Medical Transport (VAN)
  • Wiggins, MS
  • NPI 1396410577
  NPD Authorized official

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

{
    "created_epoch": "1641427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641427200000",
    "number": "1497416994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 SECOND AVE E",
            "city": "WIGGINS",
            "state": "MS",
            "postal_code": "395772806",
            "telephone_number": "601-528-4563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 EAST 2ND AVENUE",
            "city": "WIGGINS",
            "state": "MS",
            "postal_code": "39577",
            "telephone_number": "601-528-4563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFEWAY TRANSPORTATION SERVICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-06",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SANETHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-528-4563"
    },
    "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": "1-601-528-4563",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "E-Mail",
            "affiliation": "N",
            "address_1": "618 East 2nd Avenue",
            "city": "Wiggins",
            "state": "MS",
            "country_code": "US",
            "postal_code": "39577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Wiggins, MS
• Providers in Wiggins, MS by specialty
• Non-emergency Medical Transport (VAN) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; 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.