Provider Demographics
NPI:1427401025
Name:JOLLY TRANSPORT INCORPORATED
Entity type:Organization
Organization Name:JOLLY TRANSPORT INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE SECRETARY/COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOY
Authorized Official - Middle Name:S
Authorized Official - Last Name:DELA CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-224-1848
Mailing Address - Street 1:269 EVERGREEN CT
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-6220
Mailing Address - Country:US
Mailing Address - Phone:323-828-5658
Mailing Address - Fax:
Practice Address - Street 1:269 EVERGREEN CT
Practice Address - Street 2:
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702-6220
Practice Address - Country:US
Practice Address - Phone:323-828-5658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-19
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)