Provider Demographics
NPI:1598365017
Name:THERE AND BACK TRANSPORTATION LLC
Entity Type:Organization
Organization Name:THERE AND BACK TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:937-559-2669
Mailing Address - Street 1:2010 PARKHILL DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-2716
Mailing Address - Country:US
Mailing Address - Phone:937-559-2669
Mailing Address - Fax:937-723-7435
Practice Address - Street 1:2010 PARKHILL DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-2716
Practice Address - Country:US
Practice Address - Phone:937-559-2669
Practice Address - Fax:937-723-7435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)