MEDICARE: TD NON-EMERGENCY TRANSPORTATION AND LOGISTICS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1467199661
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TD NON-EMERGENCY TRANSPORTATION AND LOGISTICS, LLC

Provider Business Mailing Address
First Line	:	24 EMERY HILL RD
Second Line	:
City	:	ELGIN
State	:	SC
Zip	:	29045-8454
Country	:	US
Telephone Number	:	803-729-4137
Fax Number	:

Provider Business Practice Location Address
First Line	:	24 EMERY HILL RD
Second Line	:
City	:	ELGIN
State	:	SC
Zip	:	29045-8454
Country	:	US
Telephone Number	:	803-729-4137
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER/CEO
Name	:	MRS. TAMMIE L WILLIAMS
Credential	:
Telephone Number	:	803-729-4137

Provider Enumeration Date	:	05/18/2022
Last Update Date	:	05/18/2022

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