Provider Demographics
NPI:1538661558
Name:MEDILOGISTICS LLC
Entity Type:Organization
Organization Name:MEDILOGISTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEMT- MANAGER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ESTER
Authorized Official - Middle Name:MARY-LOUISE
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-284-8669
Mailing Address - Street 1:1616 W SHAW AVE STE B4
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-3513
Mailing Address - Country:US
Mailing Address - Phone:559-284-8669
Mailing Address - Fax:559-570-0194
Practice Address - Street 1:1616 W SHAW AVE STE B4
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3513
Practice Address - Country:US
Practice Address - Phone:559-284-8669
Practice Address - Fax:559-570-0194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)