Provider Demographics
NPI:1801418827
Name:C-CLASS TRANSPORT INC
Entity Type:Organization
Organization Name:C-CLASS TRANSPORT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:CLERSAINVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-703-1812
Mailing Address - Street 1:3615 SW 52ND AVE APT B203
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33023-6942
Mailing Address - Country:US
Mailing Address - Phone:754-703-1812
Mailing Address - Fax:
Practice Address - Street 1:3615 SW 52ND AVE APT B203
Practice Address - Street 2:
Practice Address - City:PEMBROKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33023-6942
Practice Address - Country:US
Practice Address - Phone:754-703-1812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)