Provider Demographics
NPI:1750938262
Name:TLC NON EMERGENCY MEDICAL TRANSPORT LLC
Entity type:Organization
Organization Name:TLC NON EMERGENCY MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:THELBERT
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CHILDRESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-548-9731
Mailing Address - Street 1:928 GREENWOOD AVENUE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541
Mailing Address - Country:US
Mailing Address - Phone:434-548-9731
Mailing Address - Fax:
Practice Address - Street 1:928 GREENWOOD AVENUE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-2454
Practice Address - Country:US
Practice Address - Phone:434-548-9731
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)