Provider Demographics
NPI:1255058665
Name:MEDGO TRANSPORT LLC
Entity type:Organization
Organization Name:MEDGO TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICEPRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MORENO
Authorized Official - Suffix:
Authorized Official - Credentials:VP
Authorized Official - Phone:787-245-0000
Mailing Address - Street 1:B5 ST. TABONUCO
Mailing Address - Street 2:SUITE 216 PMB 192
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968-0096
Mailing Address - Country:US
Mailing Address - Phone:787-245-0000
Mailing Address - Fax:
Practice Address - Street 1:URB PUERTO NUEVO
Practice Address - Street 2:AVE ANDALUCIA #505
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00919
Practice Address - Country:US
Practice Address - Phone:787-245-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company