Provider Demographics
NPI:1891335238
Name:TEDLA CORPORATION
Entity Type:Organization
Organization Name:TEDLA CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:TEDLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-326-6848
Mailing Address - Street 1:PO BOX 322
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-0322
Mailing Address - Country:US
Mailing Address - Phone:908-930-2476
Mailing Address - Fax:
Practice Address - Street 1:3451 KILBURN CIR APT 722
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233-1140
Practice Address - Country:US
Practice Address - Phone:804-728-0559
Practice Address - Fax:804-800-4117
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEDLA CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-14
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)