Organization
GENESIS III TRANSPORTATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANIA M THOMPSON (PRESIDENT, CEO)
(708) 937-8339
Entity
Organization
Contact information
Practice address
64 W 154TH ST, SOUTH HOLLAND, IL 60473-1076
(708) 937-8339
(708) 566-5312
Mailing address
64 W 154TH ST, SOUTH HOLLAND, IL 60473-1076
(708) 937-8339
(708) 566-5312
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
T51281384710
IL
347C00000X
Private Vehicle
T51281384710
IL
Other
Enumeration date
04/11/2016
Last updated
04/11/2016
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