Provider Demographics
NPI:1508213760
Name:ITHACA DISPATCH
Entity Type:Organization
Organization Name:ITHACA DISPATCH
Other - Org Name:TOTAL TRANSPORTATION OF ELMIRA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:KADAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-734-3979
Mailing Address - Street 1:105 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-2107
Mailing Address - Country:US
Mailing Address - Phone:607-734-6161
Mailing Address - Fax:607-733-9593
Practice Address - Street 1:105 W 3RD ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-2107
Practice Address - Country:US
Practice Address - Phone:607-734-6161
Practice Address - Fax:607-733-9593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-18
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04123873Medicaid