Provider Demographics
NPI:1013476753
Name:TRAVEL ALONG TRANSPORTATION LLC
Entity type:Organization
Organization Name:TRAVEL ALONG TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KOMOWII
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-407-9558
Mailing Address - Street 1:3324 CRAIG DR # M278
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46323-2471
Mailing Address - Country:US
Mailing Address - Phone:219-407-9558
Mailing Address - Fax:
Practice Address - Street 1:3324 CRAIG DR # M278
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46323-2471
Practice Address - Country:US
Practice Address - Phone:219-407-9558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)