Provider Demographics
NPI:1518566579
Name:TRANS-CARE OF PANAMA
Entity Type:Organization
Organization Name:TRANS-CARE OF PANAMA
Other - Org Name:KEIDRIC V COOK SR SOLE MBR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEIDRICK
Authorized Official - Middle Name:V
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:PRESIDENT
Authorized Official - Phone:850-832-7042
Mailing Address - Street 1:401 N CHURCH AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-4763
Mailing Address - Country:US
Mailing Address - Phone:850-832-7042
Mailing Address - Fax:
Practice Address - Street 1:401 N CHURCH AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-4763
Practice Address - Country:US
Practice Address - Phone:850-832-7042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)