Provider Demographics
NPI:1457694119
Name:MV PUBLIC TRANSPORTATION, INC.
Entity Type:Organization
Organization Name:MV PUBLIC TRANSPORTATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUJABBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-343-2572
Mailing Address - Street 1:3625A DR MLK JR AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-1222
Mailing Address - Country:US
Mailing Address - Phone:907-343-2577
Mailing Address - Fax:
Practice Address - Street 1:3625A DR MLK JR AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-1222
Practice Address - Country:US
Practice Address - Phone:907-343-2577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MUNICIPALITY OF ANCHORAGE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-01
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK905256343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKHC6367Medicaid