Provider Demographics
NPI:1104373976
Name:LOCOMOTIVES TAXI LLC
Entity Type:Organization
Organization Name:LOCOMOTIVES TAXI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER / OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-404-8288
Mailing Address - Street 1:PO BOX 5644
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47903-5644
Mailing Address - Country:US
Mailing Address - Phone:765-477-1234
Mailing Address - Fax:
Practice Address - Street 1:3451 UNION ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-4485
Practice Address - Country:US
Practice Address - Phone:765-477-1234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN201348410 A344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201348410 AOtherLEGACY PROVIDER IDENTIFIER