Provider Demographics
NPI:1083131932
Name:TRINITY TRANSPORT ENTERPRISE LLC
Entity Type:Organization
Organization Name:TRINITY TRANSPORT ENTERPRISE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ADAMA
Authorized Official - Middle Name:
Authorized Official - Last Name:AYIKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-281-9356
Mailing Address - Street 1:4134 11TH AVENUE A
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-2512
Mailing Address - Country:US
Mailing Address - Phone:309-644-2404
Mailing Address - Fax:
Practice Address - Street 1:4134 11TH AVENUE A
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-2512
Practice Address - Country:US
Practice Address - Phone:309-281-9356
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)