Provider Demographics
NPI:1790508737
Name:EMD TRANSPORTATION OF STL
Entity type:Organization
Organization Name:EMD TRANSPORTATION OF STL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:314-283-7978
Mailing Address - Street 1:2255 MONTAGNE DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-1738
Mailing Address - Country:US
Mailing Address - Phone:314-283-7978
Mailing Address - Fax:
Practice Address - Street 1:2255 MONTAGNE DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-1738
Practice Address - Country:US
Practice Address - Phone:314-283-7978
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)