Provider Demographics
NPI:1144923913
Name:MCJ TRUCKING AND LOGISTICS LLC
Entity type:Organization
Organization Name:MCJ TRUCKING AND LOGISTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:
Authorized Official - First Name:LORENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-313-1117
Mailing Address - Street 1:12451 NORMA LN
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63138-1461
Mailing Address - Country:US
Mailing Address - Phone:314-313-1117
Mailing Address - Fax:
Practice Address - Street 1:12451 NORMA LN
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63138-1461
Practice Address - Country:US
Practice Address - Phone:314-313-1117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)