Provider Demographics
NPI:1417385550
Name:MEDICK TRANSPORTATION INC
Entity Type:Organization
Organization Name:MEDICK TRANSPORTATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NOREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHURCHIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-804-1674
Mailing Address - Street 1:1045 JUSTIN AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-2148
Mailing Address - Country:US
Mailing Address - Phone:323-804-1674
Mailing Address - Fax:818-243-3430
Practice Address - Street 1:1045 JUSTIN AVE APT 7
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201-2148
Practice Address - Country:US
Practice Address - Phone:323-804-1674
Practice Address - Fax:818-243-3430
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICK TRANSPORTATION INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)