Provider Demographics
NPI:1710468442
Name:COACH TRANSPORTATION LLC
Entity Type:Organization
Organization Name:COACH TRANSPORTATION LLC
Other - Org Name:COACH TRANSPORTATION LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LORENZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-670-9378
Mailing Address - Street 1:1780 DUCHESS CT
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49445-1716
Mailing Address - Country:US
Mailing Address - Phone:231-670-9378
Mailing Address - Fax:
Practice Address - Street 1:1780 DUCHESS CT
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49445-1716
Practice Address - Country:US
Practice Address - Phone:231-670-9378
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)