Provider Demographics
NPI:1184895609
Name:TREACEA, PITTER, AND RILEY LLC
Entity type:Organization
Organization Name:TREACEA, PITTER, AND RILEY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER/ OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TREACEA
Authorized Official - Middle Name:NICOLA
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:BUSINESS OWNER
Authorized Official - Phone:856-419-0112
Mailing Address - Street 1:201 BLACKWOOD CLEMENTON RD APT 1710
Mailing Address - Street 2:
Mailing Address - City:LINDENWOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-6848
Mailing Address - Country:US
Mailing Address - Phone:856-419-0112
Mailing Address - Fax:856-282-7497
Practice Address - Street 1:201 BLACKWOOD CLEMENTON RD APT 1710
Practice Address - Street 2:LINDENWOLD APARTMENTS
Practice Address - City:LINDENWOLD
Practice Address - State:NJ
Practice Address - Zip Code:08021-6848
Practice Address - Country:US
Practice Address - Phone:856-419-0112
Practice Address - Fax:856-282-7497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)