Provider Demographics
NPI:1386260230
Name:MILLENNIAL TRANSPORTATION SERVICES
Entity type:Organization
Organization Name:MILLENNIAL TRANSPORTATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:NICHOLE
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-507-2568
Mailing Address - Street 1:445 STONE CANYON DR
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:TX
Mailing Address - Zip Code:75182-4605
Mailing Address - Country:US
Mailing Address - Phone:214-507-2568
Mailing Address - Fax:972-226-0704
Practice Address - Street 1:445 STONE CANYON DR
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:TX
Practice Address - Zip Code:75182-4605
Practice Address - Country:US
Practice Address - Phone:214-507-2568
Practice Address - Fax:972-226-0704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX16606230OtherDRIVERS LICENSE