Provider Demographics
NPI:1629321104
Name:COR-WIN TRANSPORT, LLC
Entity Type:Organization
Organization Name:COR-WIN TRANSPORT, LLC
Other - Org Name:MID-CITIES MEDICAL TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CORRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-944-4516
Mailing Address - Street 1:2921 E MIRALOMA AVE
Mailing Address - Street 2:SUITE 12
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806-1839
Mailing Address - Country:US
Mailing Address - Phone:714-238-9005
Mailing Address - Fax:714-238-9085
Practice Address - Street 1:2921 E MIRALOMA AVE
Practice Address - Street 2:SUITE 12
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92806-1839
Practice Address - Country:US
Practice Address - Phone:714-238-9005
Practice Address - Fax:714-238-9085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-20
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMTN01213F343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)