Provider Demographics
NPI:1881720951
Name:G & S TRANSPORTATION SERVICE, INC
Entity type:Organization
Organization Name:G & S TRANSPORTATION SERVICE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHESTENKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-821-0200
Mailing Address - Street 1:7040 HAWTHORN AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-6941
Mailing Address - Country:US
Mailing Address - Phone:323-821-0200
Mailing Address - Fax:323-960-9104
Practice Address - Street 1:425 S FAIRFAX AVE
Practice Address - Street 2:SUITE 214
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-3541
Practice Address - Country:US
Practice Address - Phone:323-939-1835
Practice Address - Fax:323-857-5622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-25
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTN01202FMedicaid