Provider Demographics
NPI: | 1932811767 |
---|---|
Name: | TAFT TRANSIT LLC |
Entity type: | Organization |
Organization Name: | TAFT TRANSIT LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | CRYSTAL |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | TAFT |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 336-207-0171 |
Mailing Address - Street 1: | 4615 W GATE CITY BLVD # 7147 |
Mailing Address - Street 2: | |
Mailing Address - City: | GREENSBORO |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 27407-4239 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 336-207-0171 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 4615 W GATE CITY BLVD # 7147 |
Practice Address - Street 2: | |
Practice Address - City: | GREENSBORO |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27407-4239 |
Practice Address - Country: | US |
Practice Address - Phone: | 336-207-0171 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2022-12-26 |
Last Update Date: | 2023-04-14 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NC | 172A00000X | Medicaid |