Provider Demographics
NPI:1386118644
Name:COVENANT LUXURY TRANSPORTATION LLC
Entity type:Organization
Organization Name:COVENANT LUXURY TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:GUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-261-6420
Mailing Address - Street 1:9353 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-5424
Mailing Address - Country:US
Mailing Address - Phone:562-444-0144
Mailing Address - Fax:
Practice Address - Street 1:9353 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-5424
Practice Address - Country:US
Practice Address - Phone:562-444-0144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)