Provider Demographics
NPI:1205826476
Name:L-J-L TRUCKING INC.
Entity Type:Organization
Organization Name:L-J-L TRUCKING INC.
Other - Org Name:MED-VAN TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:YACHTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-948-6170
Mailing Address - Street 1:1311 PHILADELPHIA AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHERN CAMBRIA
Mailing Address - State:PA
Mailing Address - Zip Code:15714-1181
Mailing Address - Country:US
Mailing Address - Phone:814-948-6170
Mailing Address - Fax:814-948-6184
Practice Address - Street 1:1311 PHILADELPHIA AVE
Practice Address - Street 2:
Practice Address - City:NORTHERN CAMBRIA
Practice Address - State:PA
Practice Address - Zip Code:15714
Practice Address - Country:US
Practice Address - Phone:814-948-6170
Practice Address - Fax:814-948-6184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-27
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA11203333300000X, 341600000X
PAA-00112962343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No333300000XSuppliersEmergency Response System Companies
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA150075OtherUMWA PROVIDER NUMBER
PA226349OtherBLUE CROSS
PA1006807870004Medicaid
PA1036516OtherGATEWAY HEALTH PLAN #
PA590010965OtherRAILROAD MEDICARE NUMBER
PA150075OtherUMWA PROVIDER NUMBER