Healthcare Provider Details

I. General information

NPI: 1093905358
Provider Name (Legal Business Name): MV TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2007
Last Update Date: 08/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10170 CROYDON WAY STE #A
SACRAMENTO CA
95827
US

IV. Provider business mailing address

360 CAMPUS LANE STE #201
FAIRFIELD CA
94534
US

V. Phone/Fax

Practice location:
  • Phone: 916-854-2638
  • Fax: 916-854-4540
Mailing address:
  • Phone: 707-863-8980
  • Fax: 707-863-8712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: GARY LAMONT RICHARDSON
Title or Position: CFO
Credential:
Phone: 707-863-8709