Provider Demographics
NPI:1013473727
Name:MC TRANSPORTATION LLC
Entity Type:Organization
Organization Name:MC TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEMENTS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:434-532-6136
Mailing Address - Street 1:3327 PLEASANT GROVE RD
Mailing Address - Street 2:
Mailing Address - City:BRODNAX
Mailing Address - State:VA
Mailing Address - Zip Code:23920-3335
Mailing Address - Country:US
Mailing Address - Phone:434-532-6136
Mailing Address - Fax:
Practice Address - Street 1:318 BLANK LN
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:VA
Practice Address - Zip Code:23847-6333
Practice Address - Country:US
Practice Address - Phone:434-532-6136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-18
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)