1134260078 NPI number — MEDICAL TRANSPORTATION MANAGEMENT, INC.

Table of content: (NPI 1134260078)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134260078 NPI number — MEDICAL TRANSPORTATION MANAGEMENT, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEDICAL TRANSPORTATION MANAGEMENT, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PRIMARY NPI
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134260078
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/31/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16 HAWKRIDGE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAKE ST LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63367-1829
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
636-561-5686
Provider Business Mailing Address Fax Number:
636-561-2962

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16 HAWK RIDGE CIR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAKE ST LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63367-1861
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
636-561-5686
Provider Business Practice Location Address Fax Number:
636-561-2962
Provider Enumeration Date:
02/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MACIA
Authorized Official First Name:
ALAINA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT AND CEO
Authorized Official Telephone Number:
636-561-5686

Provider Taxonomy Codes

  • Taxonomy code: 343800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 343900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 347E00000X , with the licence number: 8546495000 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1014658730002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1134260078 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 14218402-5 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 335022501-5 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8390569 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1134260078 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 500771054 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1134260078 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 14218404-4 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1134260078 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 117509 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 14218403-3 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3123776 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10026791901 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 14218401-6 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 14218405-7 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 335021701-9 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7034248 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1134260078 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 14218400-8 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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