Provider Demographics
NPI:1962040428
Name:ROBERTS PRIVATE TRANSPORT
Entity Type:Organization
Organization Name:ROBERTS PRIVATE TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DRIVER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-441-0577
Mailing Address - Street 1:503 N ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:BELLE CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43310-9717
Mailing Address - Country:US
Mailing Address - Phone:937-441-0577
Mailing Address - Fax:
Practice Address - Street 1:503 N ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:BELLE CENTER
Practice Address - State:OH
Practice Address - Zip Code:43310-9717
Practice Address - Country:US
Practice Address - Phone:937-441-0577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-16
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty