Provider Demographics
NPI:1053513895
Name:FOUR J'S TRANSPORTATION INC.
Entity type:Organization
Organization Name:FOUR J'S TRANSPORTATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:POLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-937-5823
Mailing Address - Street 1:PO BOX 107
Mailing Address - Street 2:
Mailing Address - City:PORT CHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10573-0107
Mailing Address - Country:US
Mailing Address - Phone:914-937-5823
Mailing Address - Fax:203-748-3725
Practice Address - Street 1:132 PEARL ST STE A
Practice Address - Street 2:
Practice Address - City:PORT CHESTER
Practice Address - State:NY
Practice Address - Zip Code:10573-7615
Practice Address - Country:US
Practice Address - Phone:914-937-5823
Practice Address - Fax:203-748-3725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172A00000X, 343900000X, 347C00000X, 347E00000X
NY01937993344600000X, 344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes344600000XTransportation ServicesTaxi
No172A00000XOther Service ProvidersDriverGroup - Multi-Specialty
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No347E00000XTransportation ServicesTransportation BrokerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01937993Medicaid