Provider Demographics
NPI:1801854468
Name:MEDREACH INC.
Entity Type:Organization
Organization Name:MEDREACH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNAB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-868-5103
Mailing Address - Street 1:1303 KONA DR
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90220-5408
Mailing Address - Country:US
Mailing Address - Phone:310-868-5103
Mailing Address - Fax:310-868-5373
Practice Address - Street 1:1303 KONA DR
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220-5408
Practice Address - Country:US
Practice Address - Phone:310-868-5103
Practice Address - Fax:310-868-5373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA388250713416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTE00340FMedicaid
CAMTE00340FMedicaid
CA=========OtherTAX ID