Provider Demographics
NPI:1528816873
Name:MEDCO MEDICAL TRANSPORTATION
Entity type:Organization
Organization Name:MEDCO MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:GARY
Authorized Official - Last Name:ASOURIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-250-9334
Mailing Address - Street 1:127 S BRAND BLVD STE B111
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-5100
Mailing Address - Country:US
Mailing Address - Phone:747-250-9334
Mailing Address - Fax:
Practice Address - Street 1:127 S BRAND BLVD STE B111
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-5100
Practice Address - Country:US
Practice Address - Phone:747-250-9334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No3416L0300XTransportation ServicesAmbulanceLand Transport
No347C00000XTransportation ServicesPrivate Vehicle