Provider Demographics
NPI:1104213818
Name:SOUTHCENTRALTRANSPORTATION
Entity Type:Organization
Organization Name:SOUTHCENTRALTRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TYAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BREDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-848-3129
Mailing Address - Street 1:102 E LINCOLN ST
Mailing Address - Street 2:PO BOX 54
Mailing Address - City:CEYLON
Mailing Address - State:MN
Mailing Address - Zip Code:56121-4033
Mailing Address - Country:US
Mailing Address - Phone:507-848-3129
Mailing Address - Fax:507-632-4273
Practice Address - Street 1:102 E LINCOLN ST
Practice Address - Street 2:
Practice Address - City:CEYLON
Practice Address - State:MN
Practice Address - Zip Code:56121-4033
Practice Address - Country:US
Practice Address - Phone:507-848-3129
Practice Address - Fax:507-632-4273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi