Provider Demographics
NPI:1275252603
Name:TLC UNDERGROUND TRUCKING LLC
Entity Type:Organization
Organization Name:TLC UNDERGROUND TRUCKING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TARSHAONTE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAUSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-216-5156
Mailing Address - Street 1:904 STONE RDG
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30252-5010
Mailing Address - Country:US
Mailing Address - Phone:404-216-5156
Mailing Address - Fax:
Practice Address - Street 1:3863 HIGHWAY 138 SE UNIT 246
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-4143
Practice Address - Country:US
Practice Address - Phone:404-216-5156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health