Healthcare Provider Details

I. General information

NPI: 1497509285
Provider Name (Legal Business Name): OGMC TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2024
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 BIRDSEY ST
BRIDGEPORT CT
06610-2508
US

IV. Provider business mailing address

71 BIRDSEY ST
BRIDGEPORT CT
06610-2508
US

V. Phone/Fax

Practice location:
  • Phone: 203-243-4833
  • Fax: 860-955-1424
Mailing address:
  • Phone: 203-243-4833
  • Fax: 860-955-1424

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: MARVALYN R HOWLETT
Title or Position: OWNER
Credential:
Phone: 203-243-4833