Provider Demographics
NPI:1801439138
Name:AMERICAN GROUND TRANSPORTATION, LLC
Entity type:Organization
Organization Name:AMERICAN GROUND TRANSPORTATION, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:KONSTANTINOS
Authorized Official - Middle Name:
Authorized Official - Last Name:RODITIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-279-0192
Mailing Address - Street 1:751 S WEIR CANYON RD STE 157-160
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92808-1962
Mailing Address - Country:US
Mailing Address - Phone:714-279-0192
Mailing Address - Fax:714-279-9652
Practice Address - Street 1:1767 N BATAVIA ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92865-4103
Practice Address - Country:US
Practice Address - Phone:714-279-0192
Practice Address - Fax:714-279-9652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-18
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi
No347E00000XTransportation ServicesTransportation Broker