Provider Demographics
NPI:1962845396
Name:LUCAS MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:LUCAS MEDICAL TRANSPORTATION LLC
Other - Org Name:LUCAS MEDICAL TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT/CHAIRMAN/CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:LUCAS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:612-570-7222
Mailing Address - Street 1:870 GROVE ST SW
Mailing Address - Street 2:SUITE B
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350-3185
Mailing Address - Country:US
Mailing Address - Phone:612-570-7222
Mailing Address - Fax:320-455-9369
Practice Address - Street 1:870 GROVE ST SW
Practice Address - Street 2:SUITE B
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-3185
Practice Address - Country:US
Practice Address - Phone:612-570-7222
Practice Address - Fax:320-455-9363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-16
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)