Provider Demographics
NPI:1376793000
Name:MED X TRANSPORTATION, LLC
Entity Type:Organization
Organization Name:MED X TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LLC MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:VIELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-230-0300
Mailing Address - Street 1:360 GENDRON RD
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06374-1777
Mailing Address - Country:US
Mailing Address - Phone:860-230-0300
Mailing Address - Fax:
Practice Address - Street 1:360 GENDRON RD
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:CT
Practice Address - Zip Code:06374-1777
Practice Address - Country:US
Practice Address - Phone:860-230-0300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT343900000X343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)