Provider Demographics
NPI:1417318734
Name:ACT TRANSPORTATION
Entity Type:Organization
Organization Name:ACT TRANSPORTATION
Other - Org Name:ACT AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:W
Authorized Official - Last Name:ADCOCK
Authorized Official - Suffix:JR
Authorized Official - Credentials:NRP/CCP
Authorized Official - Phone:240-674-2774
Mailing Address - Street 1:4536 OWENSVILLE SUDLEY RD
Mailing Address - Street 2:
Mailing Address - City:HARWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20776-9403
Mailing Address - Country:US
Mailing Address - Phone:240-674-2774
Mailing Address - Fax:
Practice Address - Street 1:4536 OWENSVILLE SUDLEY RD
Practice Address - Street 2:
Practice Address - City:HARWOOD
Practice Address - State:MD
Practice Address - Zip Code:20776-9403
Practice Address - Country:US
Practice Address - Phone:240-674-2774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-14
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport