Provider Demographics
NPI:1386347094
Name:CCC&P. TRANSPORTATION COMPANY LLC
Entity type:Organization
Organization Name:CCC&P. TRANSPORTATION COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:FONDA
Authorized Official - Middle Name:RONDELL
Authorized Official - Last Name:FRAZIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-925-1160
Mailing Address - Street 1:311 DEPOT ST
Mailing Address - Street 2:
Mailing Address - City:YOUNGWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:15697-1637
Mailing Address - Country:US
Mailing Address - Phone:724-925-1160
Mailing Address - Fax:
Practice Address - Street 1:311 DEPOT ST
Practice Address - Street 2:
Practice Address - City:YOUNGWOOD
Practice Address - State:PA
Practice Address - Zip Code:15697-1637
Practice Address - Country:US
Practice Address - Phone:724-925-1160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi