Provider Demographics
NPI:1891511101
Name:DTB OF ALABAMA LLC
Entity type:Organization
Organization Name:DTB OF ALABAMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YVETTE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-744-7475
Mailing Address - Street 1:2574 OLD LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:TALLADEGA
Mailing Address - State:AL
Mailing Address - Zip Code:35160-8934
Mailing Address - Country:US
Mailing Address - Phone:205-847-0865
Mailing Address - Fax:205-584-4508
Practice Address - Street 1:2574 OLD LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:TALLADEGA
Practice Address - State:AL
Practice Address - Zip Code:35160-8934
Practice Address - Country:US
Practice Address - Phone:205-847-0865
Practice Address - Fax:205-584-4508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)