Provider Demographics
NPI:1588129605
Name:ROOTED TRANSPORT SOLUTIONS, LLC
Entity type:Organization
Organization Name:ROOTED TRANSPORT SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TYRONE
Authorized Official - Middle Name:
Authorized Official - Last Name:PICKENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-553-2070
Mailing Address - Street 1:1193 S GROVE AVE UNIT 8
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-3002
Mailing Address - Country:US
Mailing Address - Phone:217-553-2070
Mailing Address - Fax:217-717-9100
Practice Address - Street 1:1193 S GROVE AVE UNIT 8
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304-3002
Practice Address - Country:US
Practice Address - Phone:217-553-2070
Practice Address - Fax:217-717-9100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-02
Last Update Date:2019-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle