1366954984 NPI number — MAJESTIC CARE TRANSPORTATION INC.

Table of content: (NPI 1366954984)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366954984 NPI number — MAJESTIC CARE TRANSPORTATION INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MAJESTIC CARE TRANSPORTATION 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:
MAJESTIC CARE TRANSPORTATION
Provider Other Organization Name Type Code:
3
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:
1366954984
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/15/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
34178 DUKE LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FREMONT
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94555-2524
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-303-7822
Provider Business Mailing Address Fax Number:
510-745-8479

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3524 BREAKWATER AVE UNIT A107
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAYWARD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94545-3603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-303-7822
Provider Business Practice Location Address Fax Number:
844-270-1224
Provider Enumeration Date:
11/05/2017

Additional Information

Authorized Official

Authorized Official Last Name:
MERCADO
Authorized Official First Name:
ARMAN
Authorized Official Middle Name:
CORSAME
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
408-806-3558

Provider Taxonomy Codes

  • Taxonomy code: 343900000X , with the licence number:  083849 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2023 www.npivalidator.com