Provider Demographics
NPI:1013276500
Name:MKJ AND ASSOCIATES LLC/DBA PRIMARY EXPRESS MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:MKJ AND ASSOCIATES LLC/DBA PRIMARY EXPRESS MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:MALANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-261-9244
Mailing Address - Street 1:12234 CLYDESDALE DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-9041
Mailing Address - Country:US
Mailing Address - Phone:909-261-9244
Mailing Address - Fax:909-463-9242
Practice Address - Street 1:12234 CLYDESDALE DR
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91739-9041
Practice Address - Country:US
Practice Address - Phone:909-261-9244
Practice Address - Fax:909-463-9242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-03
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)