Provider Demographics
NPI:1336685023
Name:CMT MEDICAL TRANSPORT SOLUTIONS, LLC
Entity Type:Organization
Organization Name:CMT MEDICAL TRANSPORT SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CATACUTAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-603-7613
Mailing Address - Street 1:568 NEW WELL AVE
Mailing Address - Street 2:
Mailing Address - City:LATHROP
Mailing Address - State:CA
Mailing Address - Zip Code:95330-8972
Mailing Address - Country:US
Mailing Address - Phone:209-603-7613
Mailing Address - Fax:
Practice Address - Street 1:8030 LORRAINE AVE STE 335
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95210-4225
Practice Address - Country:US
Practice Address - Phone:800-315-6918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17-00126357343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)