Provider Demographics
NPI:1043046071
Name:MRV TRANSPORTATION LLC
Entity type:Organization
Organization Name:MRV TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MACKENZIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VANCOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-858-7831
Mailing Address - Street 1:19 ROSE ST APT 4
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-2379
Mailing Address - Country:US
Mailing Address - Phone:617-868-7831
Mailing Address - Fax:
Practice Address - Street 1:19 ROSE ST APT 4
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-2379
Practice Address - Country:US
Practice Address - Phone:617-868-7831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response AttendantGroup - Multi-Specialty
No172A00000XOther Service ProvidersDriver
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle