Provider Demographics
NPI:1356983548
Name:CITY MEDICAL TRANSPORT CORPORATION
Entity type:Organization
Organization Name:CITY MEDICAL TRANSPORT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALESAN
Authorized Official - Middle Name:DEL
Authorized Official - Last Name:ACEVEDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-725-7774
Mailing Address - Street 1:135 E MCFARLAN ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07801-3536
Mailing Address - Country:US
Mailing Address - Phone:973-366-0800
Mailing Address - Fax:973-366-6241
Practice Address - Street 1:135 E MCFARLAN ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NJ
Practice Address - Zip Code:07801-3536
Practice Address - Country:US
Practice Address - Phone:973-366-0800
Practice Address - Fax:973-366-6241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)