Provider Demographics
NPI:1023736394
Name:COMMUNITY TRANSPORT SERVICE LLC
Entity type:Organization
Organization Name:COMMUNITY TRANSPORT SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CABAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-217-2458
Mailing Address - Street 1:487 NEW MIDDLETON HWY
Mailing Address - Street 2:
Mailing Address - City:GORDONSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38563-6514
Mailing Address - Country:US
Mailing Address - Phone:931-217-2458
Mailing Address - Fax:
Practice Address - Street 1:487 NEW MIDDLETON HWY
Practice Address - Street 2:
Practice Address - City:GORDONSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38563-6514
Practice Address - Country:US
Practice Address - Phone:931-217-2458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-22
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No342000000XTransportation ServicesTransportation Network Company