Healthcare Provider Details

I. General information

NPI: 1144212465
Provider Name (Legal Business Name): TLC TRANSPORTATION, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2005
Last Update Date: 12/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3991 ATTAWA AVE
SACRAMENTO CA
95822-1414
US

IV. Provider business mailing address

PO BOX 5218
SACRAMENTO CA
95817-0218
US

V. Phone/Fax

Practice location:
  • Phone: 916-368-2222
  • Fax: 916-361-2307
Mailing address:
  • Phone: 916-368-2222
  • Fax: 916-361-2307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number305588
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1833
License Number StateCA

VIII. Authorized Official

Name: MS. KATHRYN FAYE WHIPPLE
Title or Position: PRESIDENT
Credential:
Phone: 916-368-2222