Provider Demographics
NPI:1205591401
Name:MED LINE TRANSPORTATION INC
Entity type:Organization
Organization Name:MED LINE TRANSPORTATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BEATRIS
Authorized Official - Middle Name:B
Authorized Official - Last Name:YERANOSIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-667-0991
Mailing Address - Street 1:21781 VENTURA BLVD # 317
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1835
Mailing Address - Country:US
Mailing Address - Phone:818-667-0991
Mailing Address - Fax:
Practice Address - Street 1:7330 BUCKEYE DR
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-2374
Practice Address - Country:US
Practice Address - Phone:818-667-0991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)