Provider Demographics
NPI:1053044404
Name:T AND T AMERICA
Entity Type:Organization
Organization Name:T AND T AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:THIMOTEE
Authorized Official - Middle Name:
Authorized Official - Last Name:ILBOUDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-365-7096
Mailing Address - Street 1:3198 HIGHWAY 412
Mailing Address - Street 2:
Mailing Address - City:COLCORD
Mailing Address - State:OK
Mailing Address - Zip Code:74338-1356
Mailing Address - Country:US
Mailing Address - Phone:479-365-7096
Mailing Address - Fax:
Practice Address - Street 1:4835 S 73RD EAST AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-6553
Practice Address - Country:US
Practice Address - Phone:479-306-5862
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-04
Last Update Date:2022-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)