Provider Demographics
NPI:1689107336
Name:ONECOMMUNITY MEDICAL TRANS LLC
Entity Type:Organization
Organization Name:ONECOMMUNITY MEDICAL TRANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-780-6889
Mailing Address - Street 1:70 ELLIS AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-4376
Mailing Address - Country:US
Mailing Address - Phone:973-444-4714
Mailing Address - Fax:973-556-1015
Practice Address - Street 1:70 ELLIS AVE APT 8
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-4376
Practice Address - Country:US
Practice Address - Phone:973-444-4714
Practice Address - Fax:973-556-1015
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ONECOMMUNITYCONNECT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-04-10
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle