Provider Demographics
NPI:1831673169
Name:TRI COUNTY TRANSPORTATION, LLC
Entity Type:Organization
Organization Name:TRI COUNTY TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:BURGIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-308-4688
Mailing Address - Street 1:22 BENNETT VILLAGE TER
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-2202
Mailing Address - Country:US
Mailing Address - Phone:716-308-4688
Mailing Address - Fax:
Practice Address - Street 1:1811 FILLMORE AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-2903
Practice Address - Country:US
Practice Address - Phone:716-308-4688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-22
Last Update Date:2018-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)