Provider Demographics
NPI:1063131670
Name:VERIDIAN MMA COMMUTE SERVICES LLC
Entity type:Organization
Organization Name:VERIDIAN MMA COMMUTE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HALLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-438-1329
Mailing Address - Street 1:7107 DUBLIN CT
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-3745
Mailing Address - Country:US
Mailing Address - Phone:682-438-1329
Mailing Address - Fax:
Practice Address - Street 1:7107 DUBLIN CT
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76002-3745
Practice Address - Country:US
Practice Address - Phone:682-438-1329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)