Provider Demographics
NPI:1952034571
Name:TYC LOGIX LLC
Entity Type:Organization
Organization Name:TYC LOGIX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DALEY
Authorized Official - Middle Name:AKIN
Authorized Official - Last Name:SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-453-4099
Mailing Address - Street 1:1710 VERSAILLES DR SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-8322
Mailing Address - Country:US
Mailing Address - Phone:404-453-4099
Mailing Address - Fax:
Practice Address - Street 1:1710 VERSAILLES DR SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-8322
Practice Address - Country:US
Practice Address - Phone:404-453-4099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-01
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)