Provider Demographics
NPI:1144868738
Name:DOWNTOWNCOFFEESHOPTAXI LLC
Entity type:Organization
Organization Name:DOWNTOWNCOFFEESHOPTAXI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:YAW
Authorized Official - Last Name:AFORNORPE
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:503-791-6728
Mailing Address - Street 1:332 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:OR
Mailing Address - Zip Code:97103-4511
Mailing Address - Country:US
Mailing Address - Phone:503-791-6728
Mailing Address - Fax:503-895-0995
Practice Address - Street 1:332 10TH ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103-4511
Practice Address - Country:US
Practice Address - Phone:503-791-6728
Practice Address - Fax:503-895-0995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-15
Last Update Date:2019-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)