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General NPI Number Information
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NPI Number | 1871815654
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Entity Type | Organization
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Legal Business Name | CHECKER CAB OF BLOOMINGTON, INC
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Dates
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Enumeration Date | 02/22/2010
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Last Update Date | 02/22/2010
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Provider Practice Location Address
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Address Line | 1508 S MAIN ST
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City | BLOOMINGTON
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State | IL
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Zip | 61701-6797
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Country | US
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Telephone | 309-828-0123
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Fax | 309-829-6464
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Provider Business Mailing Address
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Address Line | 1415 W LOCUST ST
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City | BLOOMINGTON
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State | IL
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Zip | 61701-2623
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Country | US
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Telephone | 309-828-0123
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. AARON GREGORY HALLIDAY
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Credential |
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Telephone | 309-275-5945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343800000X
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Taxonomy Name | Secured Medical Transport (VAN)
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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 | 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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Taxonomy #3
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number |
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License Number State |
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