Provider Demographics
NPI:1548977622
Name:SJD NEMT LLC
Entity type:Organization
Organization Name:SJD NEMT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRANSPORTATION SERVICE
Authorized Official - Prefix:
Authorized Official - First Name:SOOLYM
Authorized Official - Middle Name:LOVE
Authorized Official - Last Name:DJAFALO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-391-6689
Mailing Address - Street 1:200 MARYFIELD CT
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-1983
Mailing Address - Country:US
Mailing Address - Phone:808-391-6689
Mailing Address - Fax:
Practice Address - Street 1:200 MARYFIELD CT
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-1983
Practice Address - Country:US
Practice Address - Phone:808-391-6689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)