Provider Demographics
NPI:1164256632
Name:C AND J MEDICAL TRANSPORT, LLC
Entity type:Organization
Organization Name:C AND J MEDICAL TRANSPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CONSUELO
Authorized Official - Middle Name:CHRISTINA
Authorized Official - Last Name:MCCLOUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-564-6272
Mailing Address - Street 1:2502 MANDY WAY
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-3740
Mailing Address - Country:US
Mailing Address - Phone:817-946-9014
Mailing Address - Fax:
Practice Address - Street 1:2502 MANDY WAY
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-3740
Practice Address - Country:US
Practice Address - Phone:817-946-9014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-28
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)