Provider Demographics
NPI:1780125740
Name:CAS MEDICAL TRANSPORT LLC
Entity type:Organization
Organization Name:CAS MEDICAL TRANSPORT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEVEREAUX
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:LEGET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-919-0018
Mailing Address - Street 1:1101 LORRAINE DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-1839
Mailing Address - Country:US
Mailing Address - Phone:888-919-0018
Mailing Address - Fax:
Practice Address - Street 1:1101 LORRAINE DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-1839
Practice Address - Country:US
Practice Address - Phone:888-919-0018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-10
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343900000X, 347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)