Provider Demographics
NPI:1821551656
Name:RTK TRANSPORT
Entity Type:Organization
Organization Name:RTK TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:Q
Authorized Official - Last Name:TIGNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-382-0253
Mailing Address - Street 1:4465 E GENESEE ST # 166
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13214-2229
Mailing Address - Country:US
Mailing Address - Phone:315-382-0253
Mailing Address - Fax:
Practice Address - Street 1:4465 E GENESEE ST # 166
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13214-2229
Practice Address - Country:US
Practice Address - Phone:315-382-0253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RTK MANAGEMENT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)