Provider Demographics
NPI:1043810963
Name:MEDIX TRANSPORTATION LLC
Entity Type:Organization
Organization Name:MEDIX TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER / OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-365-7551
Mailing Address - Street 1:479 SUNSET POINTE DR
Mailing Address - Street 2:
Mailing Address - City:LYMAN
Mailing Address - State:SC
Mailing Address - Zip Code:29365-9332
Mailing Address - Country:US
Mailing Address - Phone:864-365-7551
Mailing Address - Fax:864-800-3046
Practice Address - Street 1:479 SUNSET POINTE DR
Practice Address - Street 2:
Practice Address - City:LYMAN
Practice Address - State:SC
Practice Address - Zip Code:29365-9332
Practice Address - Country:US
Practice Address - Phone:864-365-7551
Practice Address - Fax:864-800-3046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)