Provider Demographics
NPI:1467016394
Name:MEDJAI MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:MEDJAI MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:EPPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-812-2000
Mailing Address - Street 1:3057 NUTLEY ST STE 181
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-1931
Mailing Address - Country:US
Mailing Address - Phone:240-812-2000
Mailing Address - Fax:
Practice Address - Street 1:3057 NUTLEY ST STE 181
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-1931
Practice Address - Country:US
Practice Address - Phone:240-812-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-25
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)