Provider Demographics
NPI:1972147627
Name:TD RELIABLE TRANSPORT LLC
Entity Type:Organization
Organization Name:TD RELIABLE TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-429-6143
Mailing Address - Street 1:1462 LEGACY DR UNIT 4
Mailing Address - Street 2:
Mailing Address - City:DEKALB
Mailing Address - State:IL
Mailing Address - Zip Code:60115-2078
Mailing Address - Country:US
Mailing Address - Phone:630-429-6143
Mailing Address - Fax:
Practice Address - Street 1:1462 LEGACY DR UNIT 4
Practice Address - Street 2:
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-2078
Practice Address - Country:US
Practice Address - Phone:630-429-6143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle