Provider Demographics
NPI:1821657511
Name:MJ RELIABLE TRANSPORTATION
Entity Type:Organization
Organization Name:MJ RELIABLE TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARCHIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-861-5534
Mailing Address - Street 1:PO BOX 5734
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91221-5734
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:938 W GLENOAKS BLVD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-4200
Practice Address - Country:US
Practice Address - Phone:818-861-5534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MJ RELIABLE TRANSPORTATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-07
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)