Provider Demographics
NPI:1346809092
Name:MED CROSS MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:MED CROSS MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:INARA
Authorized Official - Middle Name:
Authorized Official - Last Name:VELYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-303-7506
Mailing Address - Street 1:PO BOX 113
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95611-0113
Mailing Address - Country:US
Mailing Address - Phone:916-303-7506
Mailing Address - Fax:916-880-5479
Practice Address - Street 1:7425 THALIA CT
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95621-5589
Practice Address - Country:US
Practice Address - Phone:916-303-7506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)