Provider Demographics
NPI:1750515086
Name:CHARITY III TRANSPORTATION SERVICES LLC
Entity type:Organization
Organization Name:CHARITY III TRANSPORTATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-302-4044
Mailing Address - Street 1:5938 ROWANBERRY DR
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-5256
Mailing Address - Country:US
Mailing Address - Phone:443-302-4044
Mailing Address - Fax:443-302-4045
Practice Address - Street 1:5938 ROWANBERRY DR
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-5256
Practice Address - Country:US
Practice Address - Phone:443-302-4044
Practice Address - Fax:443-302-4045
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PAC MANAGEMENT SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-05-15
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDL12988374343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)