Healthcare Provider Details

I. General information

NPI: 1699598227
Provider Name (Legal Business Name): T&A TRANSPORTATION SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2024
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2052 SHERWOOD LAKE DRIVE APT 4B
SCHERERVILLE IN
46375-2749
US

IV. Provider business mailing address

2052 SHERWOOD LAKE DRIVE APT 4B
SCHERERVILLE IN
46375-2749
US

V. Phone/Fax

Practice location:
  • Phone: 708-701-0589
  • Fax:
Mailing address:
  • Phone: 708-701-0589
  • Fax:

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 Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: TYSHAWN JACKSON
Title or Position: OWNER
Credential:
Phone: 708-701-0589