Provider Demographics
NPI:1649811696
Name:AMERICA MEDTRANS LLC
Entity type:Organization
Organization Name:AMERICA MEDTRANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-822-8212
Mailing Address - Street 1:124 N NOVA RD STE 5025
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-5122
Mailing Address - Country:US
Mailing Address - Phone:386-968-1529
Mailing Address - Fax:386-200-1738
Practice Address - Street 1:124 N NOVA RD STE 5025
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-5122
Practice Address - Country:US
Practice Address - Phone:386-968-1529
Practice Address - Fax:386-200-1738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)