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General NPI Number Information
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NPI Number | 1255023362
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Entity Type | Organization
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Legal Business Name | CITY TAXI EXPRESS LLC
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Dates
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Enumeration Date | 05/25/2023
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | 1912 FAIRFIELD RD
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City | PORTAGE
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State | MI
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Zip | 49002-1544
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Country | US
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Telephone | 269-267-3474
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Fax |
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Provider Business Mailing Address
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Address Line | 1110 HOTOP AVE APT 1
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City | KALAMAZOO
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State | MI
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Zip | 49048-1759
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Country | US
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Telephone | 269-267-3474
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. CORTNEY J JACKSON
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Credential |
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Telephone | 269-267-3474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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