Provider Demographics
NPI:1639685878
Name:AMAZIN CARE TRANSPORTATION LLC
Entity Type:Organization
Organization Name:AMAZIN CARE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:OLUWATOYIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MIXON-EMESEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-332-0276
Mailing Address - Street 1:7763 E MCKINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93737-9541
Mailing Address - Country:US
Mailing Address - Phone:909-332-0276
Mailing Address - Fax:
Practice Address - Street 1:7763 EAST MCKINLEY AVENUE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93737
Practice Address - Country:US
Practice Address - Phone:909-333-2027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-26
Last Update Date:2017-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
343900000X
CA343900000X, 347C00000X, 347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No347E00000XTransportation ServicesTransportation Broker