Provider Demographics
NPI:1386931780
Name:MOUNTAIN TOP TRANSPORT SERVICES, LLC
Entity type:Organization
Organization Name:MOUNTAIN TOP TRANSPORT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DORRI
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:THYDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-271-1434
Mailing Address - Street 1:P.O. BOX 1118
Mailing Address - Street 2:
Mailing Address - City:OVERGAARD
Mailing Address - State:AZ
Mailing Address - Zip Code:85933-1118
Mailing Address - Country:US
Mailing Address - Phone:855-686-7433
Mailing Address - Fax:928-535-3264
Practice Address - Street 1:2003 PENROD LN
Practice Address - Street 2:
Practice Address - City:OVERGAARD
Practice Address - State:AZ
Practice Address - Zip Code:85933-1118
Practice Address - Country:US
Practice Address - Phone:855-686-7433
Practice Address - Fax:928-535-3264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZL16778337343900000X, 344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi