Provider Demographics
NPI:1417138215
Name:CONSOLIDATED TRANSPORTATION SERVICE AGENCY
Entity Type:Organization
Organization Name:CONSOLIDATED TRANSPORTATION SERVICE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:ROHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-788-2323
Mailing Address - Street 1:10030 FOOTHILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-7102
Mailing Address - Country:US
Mailing Address - Phone:916-788-2323
Mailing Address - Fax:916-788-2585
Practice Address - Street 1:10030 FOOTHILLS BLVD
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-7102
Practice Address - Country:US
Practice Address - Phone:916-788-2323
Practice Address - Fax:916-788-2585
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRIDE INDUSTRIES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-20
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)