Provider Demographics
NPI:1316404106
Name:MEDICTRAN SERVICES LLC
Entity Type:Organization
Organization Name:MEDICTRAN SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:
Authorized Official - First Name:JULIANA
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:PETRO
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:316-650-9072
Mailing Address - Street 1:7323 E 31ST CT N
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-2212
Mailing Address - Country:US
Mailing Address - Phone:316-650-9072
Mailing Address - Fax:316-337-5873
Practice Address - Street 1:7323 E 31ST CT N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-2212
Practice Address - Country:US
Practice Address - Phone:316-650-9072
Practice Address - Fax:316-337-5873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance