Provider Demographics
NPI:1518415405
Name:MEDICAL CARE TRANSPORTATION GROUP LLC
Entity Type:Organization
Organization Name:MEDICAL CARE TRANSPORTATION GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-960-2240
Mailing Address - Street 1:2480 COMMERCIAL DR
Mailing Address - Street 2:UNIT 20
Mailing Address - City:PORT ALLEN
Mailing Address - State:LA
Mailing Address - Zip Code:70767-6182
Mailing Address - Country:US
Mailing Address - Phone:225-960-2240
Mailing Address - Fax:
Practice Address - Street 1:2480 COMMERCIAL DR
Practice Address - Street 2:UNIT 20
Practice Address - City:PORT ALLEN
Practice Address - State:LA
Practice Address - Zip Code:70767-6182
Practice Address - Country:US
Practice Address - Phone:225-960-2240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6421917343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)