Provider Demographics
NPI:1124826128
Name:MARYBELLE TRANSPORTATION SERVICES, LLC
Entity type:Organization
Organization Name:MARYBELLE TRANSPORTATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THERYL
Authorized Official - Middle Name:GWEN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:909-731-2953
Mailing Address - Street 1:1310 S RIVERSIDE AVE # 3F-414
Mailing Address - Street 2:
Mailing Address - City:RIALTO
Mailing Address - State:CA
Mailing Address - Zip Code:92376-7622
Mailing Address - Country:US
Mailing Address - Phone:909-731-2953
Mailing Address - Fax:
Practice Address - Street 1:514 E ETIWANDA AVE
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-4471
Practice Address - Country:US
Practice Address - Phone:909-731-2953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)