=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265357149
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COMMUNITY CONNECTION TRANSPORTATION L.L.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/11/2026
-----------------------------------------------------
Last Update Date | 08/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2003 S EASTON RD STE 308
-----------------------------------------------------
City | DOYLESTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18901-7100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-315-3280
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 436 N MAIN ST STE 1067
-----------------------------------------------------
City | DOYLESTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18901-3404
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-315-3280
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. ELIJAH MIMS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 215-315-3280
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------