Provider Demographics
NPI:1861154908
Name:ELYON LOGISTICS AND TRANSPORT SERVICES LLC
Entity type:Organization
Organization Name:ELYON LOGISTICS AND TRANSPORT SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:KWEKU
Authorized Official - Last Name:BANSAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-484-6464
Mailing Address - Street 1:15337 BARNABAS TRL
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-5566
Mailing Address - Country:US
Mailing Address - Phone:571-484-6464
Mailing Address - Fax:
Practice Address - Street 1:18139 TRIANGLE SHOPPING PLZ STE 213
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22026-2582
Practice Address - Country:US
Practice Address - Phone:571-484-6464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-06
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)