Provider Demographics
NPI:1083452288
Name:PEGASUS MEDICAL TRANSPORTATION LLC
Entity type:Organization
Organization Name:PEGASUS MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:UMUTONI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-758-8328
Mailing Address - Street 1:3820 VITRUVIAN WAY APT 328
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4050
Mailing Address - Country:US
Mailing Address - Phone:469-758-8328
Mailing Address - Fax:
Practice Address - Street 1:3820 VITRUVIAN WAY APT 328
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-4050
Practice Address - Country:US
Practice Address - Phone:469-758-8328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-20
Last Update Date:2024-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)