Provider Demographics
NPI:1801146030
Name:MEDICAL TRANSPORT COMPANY
Entity type:Organization
Organization Name:MEDICAL TRANSPORT COMPANY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DRIVER
Authorized Official - Prefix:MR
Authorized Official - First Name:TYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGGANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-228-7508
Mailing Address - Street 1:4521 E JENSEN ST STE 106
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-3229
Mailing Address - Country:US
Mailing Address - Phone:480-659-6807
Mailing Address - Fax:888-421-8813
Practice Address - Street 1:4521 E JENSEN ST STE 106
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-3229
Practice Address - Country:US
Practice Address - Phone:480-659-6807
Practice Address - Fax:888-421-8813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-14
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)