Provider Demographics
NPI:1598519068
Name:REYA MEDICAL TRANSPORT ,LLC
Entity Type:Organization
Organization Name:REYA MEDICAL TRANSPORT ,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNO
Authorized Official - Prefix:MS
Authorized Official - First Name:ZANTRAQUILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:312-731-5700
Mailing Address - Street 1:101 MADISON ST STE 300
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-4210
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 MADISON ST STE 300
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-4210
Practice Address - Country:US
Practice Address - Phone:312-731-5700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No341600000XTransportation ServicesAmbulance