Healthcare Provider Details

I. General information

NPI: 1891982674
Provider Name (Legal Business Name): TRI STATE TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2007
Last Update Date: 09/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1027 E VIRGINIA ST
EVANSVILLE IN
47711-5722
US

IV. Provider business mailing address

1027 E VIRGINIA ST
EVANSVILLE IN
47711-5722
US

V. Phone/Fax

Practice location:
  • Phone: 812-429-0011
  • Fax: 812-421-1128
Mailing address:
  • Phone: 812-429-0011
  • Fax: 812-421-1128

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: DEBRA DILLION
Title or Position: OWNER
Credential:
Phone: 812-429-0011