Provider Demographics
NPI:1144997529
Name:MEDICAL TRANSPORT USA LLC SERIES A MEDICAL TRANSPORT LV
Entity type:Organization
Organization Name:MEDICAL TRANSPORT USA LLC SERIES A MEDICAL TRANSPORT LV
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IOAN
Authorized Official - Middle Name:EMILIAN
Authorized Official - Last Name:BEJGU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-285-4591
Mailing Address - Street 1:3645 W OQUENDO RD STE 400
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-3145
Mailing Address - Country:US
Mailing Address - Phone:702-285-4591
Mailing Address - Fax:
Practice Address - Street 1:187 N GIBSON RD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-6713
Practice Address - Country:US
Practice Address - Phone:702-367-7433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)