Provider Demographics
NPI:1881091247
Name:CLOUD MED TRANSPORT, LLC.
Entity type:Organization
Organization Name:CLOUD MED TRANSPORT, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PETE
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-535-1394
Mailing Address - Street 1:2808 BROADWAY
Mailing Address - Street 2:#10
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-2236
Mailing Address - Country:US
Mailing Address - Phone:646-535-1394
Mailing Address - Fax:212-663-3875
Practice Address - Street 1:11615 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-6533
Practice Address - Country:US
Practice Address - Phone:646-535-1394
Practice Address - Fax:212-663-3875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-01
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY173400421347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle