Nuwave 4Support Transportation

Primary specialty

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

Legal business name

NUWAVE 4SUPPORT TRANSPORTATION

Practice address

1190 Worcester St
Indian Orchard, MA 01151-1402

Phone

(413) 302-0976

NPI assigned

Aug 13, 2024

Organization subpart

No

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

Authorized official

Name

Meryelen Perdomo

Title

Chief Operating Officer

Phone

(413) 302-0912

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1723507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1578394243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 WORCESTER ST",
            "city": "INDIAN ORCHARD",
            "state": "MA",
            "postal_code": "011511402",
            "telephone_number": "413-302-0976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 WORCESTER ST",
            "city": "INDIAN ORCHARD",
            "state": "MA",
            "postal_code": "011511402",
            "telephone_number": "413-302-0976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUWAVE 4SUPPORT TRANSPORTATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-13",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "PERDOMO",
        "authorized_official_first_name": "MERYELEN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "413-302-0912"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Indian Orchard, MA
• Providers in Indian Orchard, MA by specialty
• Non-emergency Medical Transport (VAN) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.