Provider Demographics
NPI:1336324508
Name:FAITHFUL MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:FAITHFUL MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO AND GENERAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRISTYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUMPKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-327-5331
Mailing Address - Street 1:19416 REINHART AVE
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-1934
Mailing Address - Country:US
Mailing Address - Phone:310-327-5331
Mailing Address - Fax:310-380-6831
Practice Address - Street 1:19416 REINHART AVE
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-1934
Practice Address - Country:US
Practice Address - Phone:310-327-5331
Practice Address - Fax:310-380-6831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)