Provider Demographics
NPI:1831420702
Name:HALL;S MEDICAL TRANSPORT SERVICE
Entity type:Organization
Organization Name:HALL;S MEDICAL TRANSPORT SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:AVANCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-498-6854
Mailing Address - Street 1:PO BOX 94168
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91109-4168
Mailing Address - Country:US
Mailing Address - Phone:626-398-6854
Mailing Address - Fax:626-398-9612
Practice Address - Street 1:123 S FIGUEROA ST
Practice Address - Street 2:#235N
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-2469
Practice Address - Country:US
Practice Address - Phone:626-398-6854
Practice Address - Fax:626-398-9612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-16
Last Update Date:2010-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11428876343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)