Provider Demographics
NPI:1093161184
Name:QUANTUM TRANSPORTATION LLC
Entity Type:Organization
Organization Name:QUANTUM TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALIAKSEI
Authorized Official - Middle Name:
Authorized Official - Last Name:RUDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-467-9734
Mailing Address - Street 1:16 WHITES AVE
Mailing Address - Street 2:SUITE 12
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-4313
Mailing Address - Country:US
Mailing Address - Phone:781-467-9734
Mailing Address - Fax:
Practice Address - Street 1:16 WHITES AVE
Practice Address - Street 2:SUITE 12
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-4313
Practice Address - Country:US
Practice Address - Phone:781-467-9734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-09
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)