Provider Demographics
NPI:1811787336
Name:TDB COMMUNITY TRANSPORT LLC
Entity type:Organization
Organization Name:TDB COMMUNITY TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-362-0801
Mailing Address - Street 1:2012 LANTERN DR # 74
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:GA
Mailing Address - Zip Code:30549-6995
Mailing Address - Country:US
Mailing Address - Phone:706-362-0801
Mailing Address - Fax:770-601-1742
Practice Address - Street 1:2012 LANTERN DR
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:GA
Practice Address - Zip Code:30549-6995
Practice Address - Country:US
Practice Address - Phone:706-362-0801
Practice Address - Fax:770-601-1742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-08
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)