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General NPI Number Information
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NPI Number | 1053771022
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Entity Type | Organization
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Legal Business Name | BIGNON MEDICAL TRANSPORTATION LLC
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Dates
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Enumeration Date | 03/03/2016
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Last Update Date | 03/03/2016
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Provider Practice Location Address
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Address Line | 120 MIDDLE ST # 719
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City | BRIDGEPORT
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State | CT
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Zip | 06602-9998
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Country | US
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Telephone | 203-455-1081
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Fax | 203-290-5760
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Provider Business Mailing Address
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Address Line | 120 MIDDLE ST # 719
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City | BRIDGEPORT
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State | CT
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Zip | 06602
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Country | US
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Telephone | 203-455-1081
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Fax | 203-290-5760
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Authorized Official
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Title or Position | CONTRACT MANAGER
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Name | MR. BIGNON DOMOND
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Credential |
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Telephone | 203-455-1081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 040787542
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License Number State | CT
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