Provider Demographics
NPI:1679601108
Name:BUSH FACTOR, TRANSPORTATION
Entity type:Organization
Organization Name:BUSH FACTOR, TRANSPORTATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:ALMUS
Authorized Official - Middle Name:DEMETRIUS
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:202-249-1427
Mailing Address - Street 1:1274 BARNABY TERRANCE S.E.
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032
Mailing Address - Country:US
Mailing Address - Phone:202-249-1427
Mailing Address - Fax:202-561-8859
Practice Address - Street 1:1274 BARNABY TERRANCE S.E.
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032
Practice Address - Country:US
Practice Address - Phone:202-249-1427
Practice Address - Fax:202-561-8859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC57994XXXX110404343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC036587200Medicaid
DC036863400Medicaid