Provider Demographics
NPI:1619057288
Name:EASTERN CONTRA COSTA TRANSIT
Entity Type:Organization
Organization Name:EASTERN CONTRA COSTA TRANSIT
Other - Org Name:TRI DELTA TRANSIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRIEG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-754-6622
Mailing Address - Street 1:801 WILBUR AVENUE
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509
Mailing Address - Country:US
Mailing Address - Phone:925-754-6622
Mailing Address - Fax:925-757-2530
Practice Address - Street 1:801 WILBUR AVENUE
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509
Practice Address - Country:US
Practice Address - Phone:925-754-6622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTN01068FMedicare ID - Type Unspecified