Provider Demographics
NPI:1922583947
Name:BLC TRANSPORT LLC
Entity Type:Organization
Organization Name:BLC TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:RAMOS
Authorized Official - Last Name:MERCADO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:510-862-3508
Mailing Address - Street 1:2401 MERCED ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-4200
Mailing Address - Country:US
Mailing Address - Phone:925-690-5222
Mailing Address - Fax:
Practice Address - Street 1:2401 MERCED ST STE 300
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4200
Practice Address - Country:US
Practice Address - Phone:925-690-5222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)