Provider Demographics
NPI:1518207232
Name:WEST COASTLINE TRANSPORTATION, LLC
Entity Type:Organization
Organization Name:WEST COASTLINE TRANSPORTATION, LLC
Other - Org Name:M & M FRIENDLY MEDICAL TRANSPORTATION, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARQUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-200-6896
Mailing Address - Street 1:36444 COUGAR PL
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-3013
Mailing Address - Country:US
Mailing Address - Phone:760-200-6896
Mailing Address - Fax:
Practice Address - Street 1:4011 AVENIDA DE LA PLATA
Practice Address - Street 2:SUITE #302
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-5832
Practice Address - Country:US
Practice Address - Phone:760-200-6896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi