Healthcare Provider Details

I. General information

NPI: 1922447655
Provider Name (Legal Business Name): AAA TAXI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2013
Last Update Date: 06/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1123 SAGINAW ST
BAY CITY MI
48708-5618
US

IV. Provider business mailing address

1107 SAGINAW ST
BAY CITY MI
48708-5618
US

V. Phone/Fax

Practice location:
  • Phone: 989-893-8294
  • Fax: 989-894-2315
Mailing address:
  • Phone: 989-893-8294
  • Fax: 989-894-2315

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: TIMOTHY BANASZAK
Title or Position: OWNER
Credential:
Phone: 989-893-8294