Healthcare Provider Details

I. General information

NPI: 1740585157
Provider Name (Legal Business Name): U.S. TAXI CAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2011
Last Update Date: 01/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 S ALLEN ST
CENTRALIA MO
65240-1533
US

IV. Provider business mailing address

502 S ALLEN ST
CENTRALIA MO
65240-1533
US

V. Phone/Fax

Practice location:
  • Phone: 800-823-1352
  • Fax: 888-788-4027
Mailing address:
  • Phone: 800-823-1352
  • Fax: 888-788-4027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number1097874
License Number StateMO

VIII. Authorized Official

Name: TASHA HENDREN
Title or Position: OWNER
Credential:
Phone: 800-823-1352