Provider Demographics
NPI:1780203737
Name:CTC LOGISTICS & ENTERPRISE
Entity Type:Organization
Organization Name:CTC LOGISTICS & ENTERPRISE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:D
Authorized Official - Last Name:TOLBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-361-3603
Mailing Address - Street 1:2089 HAMPSTEAD RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-2531
Mailing Address - Country:US
Mailing Address - Phone:770-361-3603
Mailing Address - Fax:
Practice Address - Street 1:2089 HAMPSTEAD RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HTS
Practice Address - State:OH
Practice Address - Zip Code:44118-2531
Practice Address - Country:US
Practice Address - Phone:770-361-3603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)