Provider Demographics
NPI:1720841364
Name:T.A.N LOGISTICS
Entity Type:Organization
Organization Name:T.A.N LOGISTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TOCHUKWU
Authorized Official - Middle Name:
Authorized Official - Last Name:UDEGBUNE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, AGPCNP-BC
Authorized Official - Phone:469-955-0703
Mailing Address - Street 1:9861 SAGINAW BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76179-5196
Mailing Address - Country:US
Mailing Address - Phone:818-626-2459
Mailing Address - Fax:
Practice Address - Street 1:9861 SAGINAW BLVD STE 300
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76179-5196
Practice Address - Country:US
Practice Address - Phone:818-626-2459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-05
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)