Healthcare Provider Details

I. General information

NPI: 1407416696
Provider Name (Legal Business Name): TRANSPORTATION ON DEMAND INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2019
Last Update Date: 06/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 E BUTLER RD STE A
MAULDIN SC
29662-2402
US

IV. Provider business mailing address

14 E BUTLER RD STE A
MAULDIN SC
29662-2402
US

V. Phone/Fax

Practice location:
  • Phone: 864-729-2011
  • Fax: 864-729-2012
Mailing address:
  • Phone: 864-729-2011
  • Fax: 864-729-2012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: JAMRLO GERORD YATES
Title or Position: PRESIDENT
Credential: BS MATHEMATICS
Phone: 864-478-7602