Provider Demographics
NPI:1932869054
Name:RELIABLE CHOICE TRANSPORTATION
Entity Type:Organization
Organization Name:RELIABLE CHOICE TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECOND OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EVKA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAYEMBE KONGOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-607-6646
Mailing Address - Street 1:209 RAMBLEWOOD DR APT 3A
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-6534
Mailing Address - Country:US
Mailing Address - Phone:217-607-6646
Mailing Address - Fax:
Practice Address - Street 1:260 NORTHLAND BLVD STE 302A
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:OH
Practice Address - Zip Code:45246-3738
Practice Address - Country:US
Practice Address - Phone:217-607-6646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-30
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)