Provider Demographics
NPI:1669945580
Name:HITCH LLC
Entity type:Organization
Organization Name:HITCH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:THEULEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-619-3896
Mailing Address - Street 1:211 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:HALBUR
Mailing Address - State:IA
Mailing Address - Zip Code:51444-7745
Mailing Address - Country:US
Mailing Address - Phone:515-619-3896
Mailing Address - Fax:
Practice Address - Street 1:211 E 6TH ST
Practice Address - Street 2:
Practice Address - City:HALBUR
Practice Address - State:IA
Practice Address - Zip Code:51444-7745
Practice Address - Country:US
Practice Address - Phone:515-619-3896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)