Provider Demographics
NPI:1295126837
Name:DECATUR CITY TAXI & DELIVERY INC
Entity type:Organization
Organization Name:DECATUR CITY TAXI & DELIVERY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:BOLIARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-330-7960
Mailing Address - Street 1:411 E WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62523-1140
Mailing Address - Country:US
Mailing Address - Phone:217-330-7960
Mailing Address - Fax:
Practice Address - Street 1:411 E WILLIAM ST
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62523-1140
Practice Address - Country:US
Practice Address - Phone:217-330-7960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)