Provider Demographics
NPI:1952575326
Name:MPB TRANSPORTATION SERVICES INCORPORATION
Entity Type:Organization
Organization Name:MPB TRANSPORTATION SERVICES INCORPORATION
Other - Org Name:MPB TRANSPORTATION SERVICES INCORPORATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MAURITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-781-9133
Mailing Address - Street 1:4831 SUMMERHILL DR
Mailing Address - Street 2:
Mailing Address - City:COUNTRY CLUB HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60478-2011
Mailing Address - Country:US
Mailing Address - Phone:708-781-9133
Mailing Address - Fax:708-575-5406
Practice Address - Street 1:4831 SUMMERHILL DR
Practice Address - Street 2:
Practice Address - City:COUNTRY CLUB HILLS
Practice Address - State:IL
Practice Address - Zip Code:60478-2011
Practice Address - Country:US
Practice Address - Phone:708-781-9133
Practice Address - Fax:708-575-5406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL001343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid