Provider Demographics
NPI:1538307079
Name:BID TRANSPORTATION
Entity Type:Organization
Organization Name:BID TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMIKA
Authorized Official - Middle Name:LATRIC
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-322-6809
Mailing Address - Street 1:114 STUART RD NE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-4803
Mailing Address - Country:US
Mailing Address - Phone:423-322-6809
Mailing Address - Fax:
Practice Address - Street 1:168 COUNTY ROAD 730
Practice Address - Street 2:
Practice Address - City:RICEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37370-5725
Practice Address - Country:US
Practice Address - Phone:423-322-6809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-21
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0043206343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)