Provider Demographics
NPI:1952843351
Name:KEUKA TAXI LLC
Entity Type:Organization
Organization Name:KEUKA TAXI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:A
Authorized Official - Last Name:VIVIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-275-7728
Mailing Address - Street 1:2076 TOWNSEND RD
Mailing Address - Street 2:
Mailing Address - City:PENN YAN
Mailing Address - State:NY
Mailing Address - Zip Code:14527-8711
Mailing Address - Country:US
Mailing Address - Phone:607-275-7728
Mailing Address - Fax:315-694-7132
Practice Address - Street 1:2076 TOWNSEND RD
Practice Address - Street 2:
Practice Address - City:PENN YAN
Practice Address - State:NY
Practice Address - Zip Code:14527-8711
Practice Address - Country:US
Practice Address - Phone:607-275-7728
Practice Address - Fax:315-694-7132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-16
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)