Provider Demographics
NPI:1417543059
Name:CHECKER MOBILITY TRANSPORT LLC
Entity Type:Organization
Organization Name:CHECKER MOBILITY TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:HAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-499-8877
Mailing Address - Street 1:P.O. BOX 547
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64802
Mailing Address - Country:US
Mailing Address - Phone:417-499-8877
Mailing Address - Fax:417-782-3030
Practice Address - Street 1:6267 COUNTY LANE 299
Practice Address - Street 2:
Practice Address - City:CARL JUNCTION
Practice Address - State:MO
Practice Address - Zip Code:64834
Practice Address - Country:US
Practice Address - Phone:417-499-8877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)