Provider Demographics
NPI:1801131446
Name:MED GENERAL INC.
Entity type:Organization
Organization Name:MED GENERAL INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREH
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIGORIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-396-0907
Mailing Address - Street 1:417 ARDEN AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-4045
Mailing Address - Country:US
Mailing Address - Phone:818-396-0907
Mailing Address - Fax:818-500-0906
Practice Address - Street 1:417 ARDEN AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-4045
Practice Address - Country:US
Practice Address - Phone:818-396-0907
Practice Address - Fax:818-500-0906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-08
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)