Provider Demographics
NPI:1386818037
Name:M C ENTERPRISES AND ASSOCIATES
Entity Type:Organization
Organization Name:M C ENTERPRISES AND ASSOCIATES
Other - Org Name:VIP TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:CHAMBBERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-921-1707
Mailing Address - Street 1:1216 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:METROPOLIS
Mailing Address - State:IL
Mailing Address - Zip Code:62960-2330
Mailing Address - Country:US
Mailing Address - Phone:618-524-3890
Mailing Address - Fax:618-524-8164
Practice Address - Street 1:1216 E 7TH ST
Practice Address - Street 2:
Practice Address - City:METROPOLIS
Practice Address - State:IL
Practice Address - Zip Code:62960-2330
Practice Address - Country:US
Practice Address - Phone:618-524-3890
Practice Address - Fax:618-524-8164
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:M C ENTERPRISES AND ASSOCIATES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL6296001344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========6296001Medicaid