Provider Demographics
NPI:1316728603
Name:COMMUNITY MEDICAL TRANSIT LLC
Entity type:Organization
Organization Name:COMMUNITY MEDICAL TRANSIT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARBAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-430-5800
Mailing Address - Street 1:5523 WOODBRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45429-2061
Mailing Address - Country:US
Mailing Address - Phone:937-430-5800
Mailing Address - Fax:
Practice Address - Street 1:5523 WOODBRIDGE LN
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-2061
Practice Address - Country:US
Practice Address - Phone:937-430-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-11
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)