Provider Demographics
NPI:1346498052
Name:MEDI-CORE TRANSPORT, INC
Entity Type:Organization
Organization Name:MEDI-CORE TRANSPORT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRISTINE
Authorized Official - Middle Name:BATO
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-552-7588
Mailing Address - Street 1:3534 HEADWATER DR
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-6340
Mailing Address - Country:US
Mailing Address - Phone:707-552-7588
Mailing Address - Fax:
Practice Address - Street 1:3534 HEADWATER DR
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94591-6340
Practice Address - Country:US
Practice Address - Phone:707-552-7588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-05
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0900006710343800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)