Healthcare Provider Details

I. General information

NPI: 1447313622
Provider Name (Legal Business Name): TLC HANDI-TRANS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99-019 KEALAKAHA DR
AIEA HI
96701-3544
US

IV. Provider business mailing address

99-019 KEALAKAHA DR
AIEA HI
96701-3544
US

V. Phone/Fax

Practice location:
  • Phone: 808-864-0579
  • Fax: 808-488-2988
Mailing address:
  • Phone: 808-864-0579
  • Fax: 808-488-2988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number1493C
License Number StateHI

VIII. Authorized Official

Name: TANNY R CAOILE
Title or Position: PRESIDENT
Credential:
Phone: 808-864-0579