Provider Demographics
NPI:1487930707
Name:WANA CAB
Entity type:Organization
Organization Name:WANA CAB
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUWANNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:WILSON-JEFFERSON
Authorized Official - Suffix:
Authorized Official - Credentials:TAXI LICENSE
Authorized Official - Phone:716-844-8437
Mailing Address - Street 1:75 ANDREWS AVE
Mailing Address - Street 2:STE. 2
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-2814
Mailing Address - Country:US
Mailing Address - Phone:716-844-8437
Mailing Address - Fax:
Practice Address - Street 1:75 ANDREWS AVE
Practice Address - Street 2:STE.2
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-2814
Practice Address - Country:US
Practice Address - Phone:716-844-8437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi