Healthcare Provider Details

I. General information

NPI: 1699049098
Provider Name (Legal Business Name): M3 TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2012
Last Update Date: 03/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 ALGONQUIN ST
BROCKTON MA
02302-2452
US

IV. Provider business mailing address

91 ALGONQUIN ST
BROCKTON MA
02302-2452
US

V. Phone/Fax

Practice location:
  • Phone: 774-259-8070
  • Fax: 508-584-9696
Mailing address:
  • Phone: 774-259-8070
  • Fax: 508-584-9696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MRS. TRACY E. MAILE
Title or Position: OWNER
Credential:
Phone: 774-259-8070