Provider Demographics
NPI:1346579844
Name:GB&C TRANSPORTATION SERVICES, LLC
Entity Type:Organization
Organization Name:GB&C TRANSPORTATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TEAM MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERRY
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:731-697-5032
Mailing Address - Street 1:213 N STATE AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46201-3835
Mailing Address - Country:US
Mailing Address - Phone:731-697-5032
Mailing Address - Fax:
Practice Address - Street 1:213 N STATE AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46201-3835
Practice Address - Country:US
Practice Address - Phone:731-697-5032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-11
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN040879269343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN461260543800937Medicaid