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General NPI Number Information
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NPI Number | 1053969790
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Entity Type | Organization
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Legal Business Name | CONSISTENT MEDICAL TRANSPORTATION
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Dates
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Enumeration Date | 08/27/2019
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Last Update Date | 11/26/2022
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Provider Practice Location Address
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Address Line | 1409 W MAIN ST APT A
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City | BELLEVILLE
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State | IL
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Zip | 62220-1528
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Country | US
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Telephone | 618-301-6848
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Fax |
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Provider Business Mailing Address
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Address Line | 1409 W MAIN ST APT A
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City | BELLEVILLE
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State | IL
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Zip | 62220-1528
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Country | US
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Telephone | 618-301-6848
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIARA SANDERS LASHAWN
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Credential |
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Telephone | 618-301-6848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number |
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License Number State |
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