Provider Demographics
NPI:1568120137
Name:C&C MED TRANSPORTATION LLC
Entity Type:Organization
Organization Name:C&C MED TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:MISS
Authorized Official - First Name:CHAUNTAE
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-451-7760
Mailing Address - Street 1:4806 ERICSON AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-5912
Mailing Address - Country:US
Mailing Address - Phone:937-451-7760
Mailing Address - Fax:
Practice Address - Street 1:4806 ERICSON AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-5912
Practice Address - Country:US
Practice Address - Phone:937-451-7760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)