Provider Demographics
NPI:1871061994
Name:MED-TRANZ LLC
Entity type:Organization
Organization Name:MED-TRANZ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAMIEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-624-8256
Mailing Address - Street 1:609 BLUE COVE TER
Mailing Address - Street 2:
Mailing Address - City:LAKE SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63367-1418
Mailing Address - Country:US
Mailing Address - Phone:314-485-7588
Mailing Address - Fax:
Practice Address - Street 1:100 S 4TH ST STE 550
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63102-1897
Practice Address - Country:US
Practice Address - Phone:314-485-7588
Practice Address - Fax:662-332-5527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)