Provider Demographics
NPI:1255023362
Name:CITY TAXI EXPRESS LLC
Entity type:Organization
Organization Name:CITY TAXI EXPRESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CORTNEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-267-3474
Mailing Address - Street 1:1110 HOTOP AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-1759
Mailing Address - Country:US
Mailing Address - Phone:269-267-3474
Mailing Address - Fax:
Practice Address - Street 1:1912 FAIRFIELD RD
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49002-1544
Practice Address - Country:US
Practice Address - Phone:269-267-3474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)