Healthcare Provider Details

I. General information

NPI: 1437394889
Provider Name (Legal Business Name): M & M FRIENDLY MEDICAL TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2008
Last Update Date: 12/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3964 LINDSAY ST
RIVERSIDE CA
92509-2565
US

IV. Provider business mailing address

3964 LINDSAY ST
RIVERSIDE CA
92509-2565
US

V. Phone/Fax

Practice location:
  • Phone: 760-535-3895
  • Fax:
Mailing address:
  • Phone: 760-535-3895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number343900000X
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number344600000X
License Number StateCA

VIII. Authorized Official

Name: MARQUIS R HARRIS
Title or Position: PRESIDENT
Credential:
Phone: 760-535-3895