Provider Demographics
NPI:1831772698
Name:SECURITY LOGISTICS INTELLIGENCE CONSTRUCTION ENGINEERING COMPANY
Entity type:Organization
Organization Name:SECURITY LOGISTICS INTELLIGENCE CONSTRUCTION ENGINEERING COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CECIL
Authorized Official - Middle Name:
Authorized Official - Last Name:AVERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-250-8739
Mailing Address - Street 1:101 S REID ST # 337
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57103-7030
Mailing Address - Country:US
Mailing Address - Phone:859-250-8739
Mailing Address - Fax:859-300-3937
Practice Address - Street 1:101 S REID ST # 337
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57103-7030
Practice Address - Country:US
Practice Address - Phone:859-250-8739
Practice Address - Fax:859-300-3937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)