Provider Demographics
| NPI: | 1932811767 |
|---|---|
| Name: | TAFT TRANSIT LLC |
| Entity type: | Organization |
| Organization Name: | TAFT TRANSIT LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | CRYSTAL |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | TAFT |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 336-207-0171 |
| Mailing Address - Street 1: | 4615 W GATE CITY BLVD # 7147 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | GREENSBORO |
| Mailing Address - State: | NC |
| Mailing Address - Zip Code: | 27407-4239 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 336-207-0171 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 4615 W GATE CITY BLVD # 7147 |
| Practice Address - Street 2: | |
| Practice Address - City: | GREENSBORO |
| Practice Address - State: | NC |
| Practice Address - Zip Code: | 27407-4239 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 336-207-0171 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2022-12-26 |
| Last Update Date: | 2023-04-14 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| NC | 172A00000X | Medicaid |