Provider Demographics
NPI:1811469158
Name:ROBINSON TRANSPORT
Entity type:Organization
Organization Name:ROBINSON TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:708-250-3454
Mailing Address - Street 1:2137 PRENTISS DR APT M310
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-2160
Mailing Address - Country:US
Mailing Address - Phone:708-250-3454
Mailing Address - Fax:
Practice Address - Street 1:2137 PRENTISS DR APT M310
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60516-2160
Practice Address - Country:US
Practice Address - Phone:708-250-3454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-27
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)