Provider Demographics
NPI:1194332213
Name:COMMUNITY MEDICAL TRANSPORT LTD
Entity type:Organization
Organization Name:COMMUNITY MEDICAL TRANSPORT LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:REGINE
Authorized Official - Middle Name:UWIMANA
Authorized Official - Last Name:MUZERWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-331-3641
Mailing Address - Street 1:749 26TH AVENUE CT
Mailing Address - Street 2:
Mailing Address - City:SILVIS
Mailing Address - State:IL
Mailing Address - Zip Code:61282-2870
Mailing Address - Country:US
Mailing Address - Phone:217-331-3641
Mailing Address - Fax:
Practice Address - Street 1:534 16TH ST STE C
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-8635
Practice Address - Country:US
Practice Address - Phone:217-331-3641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)