Provider Demographics
NPI:1730069147
Name:QUIKTRIP TRANSPORTATION LLC
Entity type:Organization
Organization Name:QUIKTRIP TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BLAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMBERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-464-8992
Mailing Address - Street 1:178 MILL RUN RD LOT 8
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:OH
Mailing Address - Zip Code:45690-8970
Mailing Address - Country:US
Mailing Address - Phone:740-835-8368
Mailing Address - Fax:
Practice Address - Street 1:178 MILL RUN RD LOT 8
Practice Address - Street 2:LOT 8
Practice Address - City:WAVERLY
Practice Address - State:OH
Practice Address - Zip Code:45690-8970
Practice Address - Country:US
Practice Address - Phone:740-835-8368
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)