Provider Demographics
NPI:1174831754
Name:MONROE RANDOLPH TRANSIT DISTRICT
Entity Type:Organization
Organization Name:MONROE RANDOLPH TRANSIT DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOOKKEEPER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEINEMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-443-4433
Mailing Address - Street 1:802 WEST SECOND
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:IL
Mailing Address - Zip Code:62286-2076
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:802 WEST SECOND
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:IL
Practice Address - Zip Code:62286-2076
Practice Address - Country:US
Practice Address - Phone:618-443-4433
Practice Address - Fax:618-443-9064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)