Healthcare Provider Details

I. General information

NPI: 1144613407
Provider Name (Legal Business Name): CCM TRANSPORTATION INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2015
Last Update Date: 03/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

643 W 172ND ST APT.5
NEW YORK NY
10032-1817
US

IV. Provider business mailing address

643 W 172ND ST APT.5
NEW YORK NY
10032-1817
US

V. Phone/Fax

Practice location:
  • Phone: 646-246-4988
  • Fax:
Mailing address:
  • Phone: 646-246-4988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MS. MARIBEL ALMONTE
Title or Position: PRESIDENT
Credential:
Phone: 646-246-4988