Provider Demographics
NPI:1770210742
Name:BLUE CAR LLC
Entity type:Organization
Organization Name:BLUE CAR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RECOIT
Authorized Official - Middle Name:MBEMBO
Authorized Official - Last Name:BASALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-256-6162
Mailing Address - Street 1:252 TURNER ST APT 2
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-6076
Mailing Address - Country:US
Mailing Address - Phone:682-256-6162
Mailing Address - Fax:
Practice Address - Street 1:252 TURNER ST APT 2
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-6076
Practice Address - Country:US
Practice Address - Phone:682-256-6162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-01
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)