Provider Demographics
NPI:1952752701
Name:PHOENIX MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:PHOENIX MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:COURTNEI
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-605-0357
Mailing Address - Street 1:2865 VAUXHALL RD
Mailing Address - Street 2:
Mailing Address - City:VAUXHALL
Mailing Address - State:NJ
Mailing Address - Zip Code:07088-1228
Mailing Address - Country:US
Mailing Address - Phone:908-605-0357
Mailing Address - Fax:908-258-7548
Practice Address - Street 1:2865 VAUXHALL RD
Practice Address - Street 2:
Practice Address - City:VAUXHALL
Practice Address - State:NJ
Practice Address - Zip Code:07088-1228
Practice Address - Country:US
Practice Address - Phone:908-605-0357
Practice Address - Fax:908-258-7548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)