Provider Demographics
NPI:1891026456
Name:TRI COUNTY CALL A RIDE LLC
Entity Type:Organization
Organization Name:TRI COUNTY CALL A RIDE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF TRANSPORTATION SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:FUNK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-889-4646
Mailing Address - Street 1:5405 21 MILE RD
Mailing Address - Street 2:PO BOX 176
Mailing Address - City:SAND LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49343-9476
Mailing Address - Country:US
Mailing Address - Phone:616-889-4646
Mailing Address - Fax:616-819-6673
Practice Address - Street 1:5405 21 MILE RD
Practice Address - Street 2:176
Practice Address - City:SAND LAKE
Practice Address - State:MI
Practice Address - Zip Code:49343-9476
Practice Address - Country:US
Practice Address - Phone:616-889-4646
Practice Address - Fax:616-819-6673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi