Provider Demographics
NPI:1144212465
Name:TLC TRANSPORTATION, INC
Entity Type:Organization
Organization Name:TLC TRANSPORTATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:FAYE
Authorized Official - Last Name:WHIPPLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-368-2222
Mailing Address - Street 1:PO BOX 5218
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-0218
Mailing Address - Country:US
Mailing Address - Phone:916-368-2222
Mailing Address - Fax:916-361-2307
Practice Address - Street 1:3991 ATTAWA AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95822-1414
Practice Address - Country:US
Practice Address - Phone:916-368-2222
Practice Address - Fax:916-361-2307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18333416L0300X
CA305588343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTN01018FMedicaid
CAMTN01018FMedicaid