Provider Demographics
NPI:1326607797
Name:BLAIR BLUE COMMUNITY TRANSPORTATION LLC
Entity Type:Organization
Organization Name:BLAIR BLUE COMMUNITY TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:W
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-490-8911
Mailing Address - Street 1:PO BOX 235
Mailing Address - Street 2:
Mailing Address - City:BLAIR
Mailing Address - State:NE
Mailing Address - Zip Code:68008-0235
Mailing Address - Country:US
Mailing Address - Phone:402-533-1133
Mailing Address - Fax:402-533-2124
Practice Address - Street 1:3348 ADAMS ST
Practice Address - Street 2:
Practice Address - City:BLAIR
Practice Address - State:NE
Practice Address - Zip Code:68008-4002
Practice Address - Country:US
Practice Address - Phone:402-533-1133
Practice Address - Fax:402-533-2124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-10
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)