Healthcare Provider Details

I. General information

NPI: 1780221770
Provider Name (Legal Business Name): JV MEDICAL TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2019
Last Update Date: 12/09/2019
Certification Date: 12/09/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4959 BARSTOW ST
LOS ANGELES CA
90032-2109
US

IV. Provider business mailing address

4959 BARSTOW ST
LOS ANGELES CA
90032-2109
US

V. Phone/Fax

Practice location:
  • Phone: 323-896-3363
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MS. VIRGINIA VACA
Title or Position: MANAGER
Credential:
Phone: 323-896-3363