Provider Demographics
NPI:1598147498
Name:THJ TRANSPORT, LLC
Entity Type:Organization
Organization Name:THJ TRANSPORT, LLC
Other - Org Name:49ER CAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:A
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-768-9637
Mailing Address - Street 1:PO BOX 5493
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-2493
Mailing Address - Country:US
Mailing Address - Phone:209-984-3333
Mailing Address - Fax:209-965-7035
Practice Address - Street 1:19506 INDUSTRIAL DR
Practice Address - Street 2:STE C2
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-9213
Practice Address - Country:US
Practice Address - Phone:209-984-3333
Practice Address - Fax:209-965-7035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-26
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB9461268343900000X, 344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi