Provider Demographics
NPI:1881100030
Name:SMART TAXI
Entity type:Organization
Organization Name:SMART TAXI
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BABATUNDE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANIMASHAUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-576-3826
Mailing Address - Street 1:2100 MADISON AVE APT 10C
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:IL
Mailing Address - Zip Code:61920-2393
Mailing Address - Country:US
Mailing Address - Phone:217-576-3826
Mailing Address - Fax:
Practice Address - Street 1:2100 MADISON AVE APT 10C
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:IL
Practice Address - Zip Code:61920-2393
Practice Address - Country:US
Practice Address - Phone:217-576-3826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-26
Last Update Date:2017-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)