Provider Demographics
NPI:1770011462
Name:MERCURY'S MEDICAL TRANSPORT SERVICE LLC
Entity Type:Organization
Organization Name:MERCURY'S MEDICAL TRANSPORT SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:STEINER
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:918-351-9931
Mailing Address - Street 1:3200 N SAN FERNANDO BLVD STE 28
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-2528
Mailing Address - Country:US
Mailing Address - Phone:819-351-9931
Mailing Address - Fax:866-888-9370
Practice Address - Street 1:3200 N SAN FERNANDO BLVD STE 28
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-2528
Practice Address - Country:US
Practice Address - Phone:818-351-9931
Practice Address - Fax:866-888-9370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-25
Last Update Date:2017-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)