Healthcare Provider Details

I. General information

NPI: 1073219689
Provider Name (Legal Business Name): AAA-1 TRANSPORTATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2023
Last Update Date: 02/06/2023
Certification Date: 02/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 ENGLE ST
DOLTON IL
60419-1719
US

IV. Provider business mailing address

630 ENGLE ST
DOLTON IL
60419-1719
US

V. Phone/Fax

Practice location:
  • Phone: 773-949-2475
  • Fax: 773-787-1519
Mailing address:
  • Phone: 773-949-2475
  • Fax: 773-787-1519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: MISS GRACE MAE THOMAS
Title or Position: OWNER
Credential:
Phone: 773-949-2475