Provider Demographics
NPI:1851760714
Name:MAKAK-2 LLC
Entity Type:Organization
Organization Name:MAKAK-2 LLC
Other - Org Name:ARCH MEDICAL TRANSPORTATION OF ST. CHARLES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:FINNEGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-925-2022
Mailing Address - Street 1:403 DROSTE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-4879
Mailing Address - Country:US
Mailing Address - Phone:636-925-2022
Mailing Address - Fax:636-925-1859
Practice Address - Street 1:403 DROSTE RD
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-4879
Practice Address - Country:US
Practice Address - Phone:636-925-2022
Practice Address - Fax:636-925-1859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO22397361343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)