Provider Demographics
NPI:1952020422
Name:CENTURION MEDICAL TRANSPORT LLC
Entity Type:Organization
Organization Name:CENTURION MEDICAL TRANSPORT LLC
Other - Org Name:CENTURION MEDICAL TRANSPORT LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-467-2109
Mailing Address - Street 1:3630 HIGH ST
Mailing Address - Street 2:#19069
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94619
Mailing Address - Country:US
Mailing Address - Phone:510-467-2109
Mailing Address - Fax:650-547-6163
Practice Address - Street 1:1516 OAK ST STE 102
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-2953
Practice Address - Country:US
Practice Address - Phone:510-467-2109
Practice Address - Fax:650-547-6163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-26
Last Update Date:2023-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)