Healthcare Provider Details

I. General information

NPI: 1770050320
Provider Name (Legal Business Name): JJ'S TAXI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2018
Last Update Date: 10/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 TIGER LN STE 201D
COLUMBIA MO
65203-8155
US

IV. Provider business mailing address

310 TIGER LN STE 201D
COLUMBIA MO
65203-8155
US

V. Phone/Fax

Practice location:
  • Phone: 573-639-6665
  • Fax:
Mailing address:
  • Phone: 573-639-6665
  • 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 Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: CONSUELA JOHNSON
Title or Position: MANAGER
Credential:
Phone: 573-673-4879