Provider Demographics
NPI:1386197424
Name:TOLO TRANPORTATION LLC
Entity Type:Organization
Organization Name:TOLO TRANPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:HADA
Authorized Official - Middle Name:MARLENE
Authorized Official - Last Name:WILTSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-451-0252
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:GRANGEVILLE
Mailing Address - State:ID
Mailing Address - Zip Code:83530-0189
Mailing Address - Country:US
Mailing Address - Phone:208-451-0252
Mailing Address - Fax:
Practice Address - Street 1:78 POOR FARM RD
Practice Address - Street 2:
Practice Address - City:GRANGEVILLE
Practice Address - State:ID
Practice Address - Zip Code:83530
Practice Address - Country:US
Practice Address - Phone:208-451-0252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)