Provider Demographics
NPI:1285013938
Name:EXCEL MED-TRANS LLC
Entity Type:Organization
Organization Name:EXCEL MED-TRANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER/ OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CLAUDIUS
Authorized Official - Middle Name:B
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-289-6467
Mailing Address - Street 1:5589 LEITRIM WAY
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-8630
Mailing Address - Country:US
Mailing Address - Phone:925-522-5461
Mailing Address - Fax:408-904-5007
Practice Address - Street 1:5589 LEITRIM WAY
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-8630
Practice Address - Country:US
Practice Address - Phone:925-522-5461
Practice Address - Fax:408-904-5007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-28
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA201505710547343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)