Healthcare Provider Details

I. General information

NPI: 1376461194
Provider Name (Legal Business Name): MEDICAL CARE TRANSPORTATION GROUP OF MISSISSIPPI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2746 ANTIOCH PERKINS RD
GLOSTER MS
39638-3589
US

IV. Provider business mailing address

2746 ANTIOCH PERKINS RD
GLOSTER MS
39638-3589
US

V. Phone/Fax

Practice location:
  • Phone: 225-439-8638
  • Fax:
Mailing address:
  • Phone: 225-439-8638
  • Fax:

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: CEDRIC R RICHARDSON
Title or Position: OWNER
Credential:
Phone: 222-254-8589