Provider Demographics
NPI:1134424526
Name:MIDAS MEDICAL TRANSPORTATION, LLC
Entity type:Organization
Organization Name:MIDAS MEDICAL TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LINDON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-858-7206
Mailing Address - Street 1:19244 LAURENRAE ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92508-6238
Mailing Address - Country:US
Mailing Address - Phone:951-858-7206
Mailing Address - Fax:951-565-8009
Practice Address - Street 1:19244 LAURENRAE ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92508-6238
Practice Address - Country:US
Practice Address - Phone:951-858-7206
Practice Address - Fax:951-565-8009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA201036510025343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)