Provider Demographics
NPI:1619454196
Name:NEXT GENERATION TAXI LLC
Entity Type:Organization
Organization Name:NEXT GENERATION TAXI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAINE
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:BLAZIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-586-4548
Mailing Address - Street 1:PO BOX 234
Mailing Address - Street 2:
Mailing Address - City:LICKING
Mailing Address - State:MO
Mailing Address - Zip Code:65542-0234
Mailing Address - Country:US
Mailing Address - Phone:573-889-9121
Mailing Address - Fax:
Practice Address - Street 1:11560 COOPER DR
Practice Address - Street 2:
Practice Address - City:LICKING
Practice Address - State:MO
Practice Address - Zip Code:65542-8138
Practice Address - Country:US
Practice Address - Phone:573-889-9121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)