Provider Demographics
NPI:1548596067
Name:MOUNTAIN HIGH TRANSPORTATION GROUP
Entity Type:Organization
Organization Name:MOUNTAIN HIGH TRANSPORTATION GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:CHRISTIAN
Authorized Official - Last Name:WIMBERLY
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:267-290-7542
Mailing Address - Street 1:227 S LINE ST APT 2
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-2528
Mailing Address - Country:US
Mailing Address - Phone:267-702-9080
Mailing Address - Fax:
Practice Address - Street 1:272 GENTRY RD
Practice Address - Street 2:
Practice Address - City:ERWIN
Practice Address - State:NC
Practice Address - Zip Code:28339-8637
Practice Address - Country:US
Practice Address - Phone:267-702-9080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-19
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA25589944343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)