Provider Demographics
NPI:1730353533
Name:WEST CENTRAL MASS TRANSIT DISTRICT
Entity type:Organization
Organization Name:WEST CENTRAL MASS TRANSIT DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:R.
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:JUMPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-245-2900
Mailing Address - Street 1:1120 W WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62650-1131
Mailing Address - Country:US
Mailing Address - Phone:217-245-2900
Mailing Address - Fax:217-245-2901
Practice Address - Street 1:1120 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:IL
Practice Address - Zip Code:62650-1131
Practice Address - Country:US
Practice Address - Phone:217-245-2900
Practice Address - Fax:217-245-2901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-14
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========6265001OtherHFS PAYEE NUMBER