Provider Demographics
NPI:1275850448
Name:FAMILY CARE MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:FAMILY CARE MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-455-6590
Mailing Address - Street 1:2851 BEDFORD LN
Mailing Address - Street 2:SUITE 165
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-3558
Mailing Address - Country:US
Mailing Address - Phone:909-455-6590
Mailing Address - Fax:360-323-9228
Practice Address - Street 1:2851 BEDFORD LN
Practice Address - Street 2:SUITE 165
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-3558
Practice Address - Country:US
Practice Address - Phone:909-816-0685
Practice Address - Fax:360-323-9228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-28
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)