Provider Demographics
NPI:1427453604
Name:MONTYS TRANNSPORTATION, LLC
Entity type:Organization
Organization Name:MONTYS TRANNSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DRIVER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTGOMERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-980-1241
Mailing Address - Street 1:PO BOX 141002
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48214-5002
Mailing Address - Country:US
Mailing Address - Phone:313-980-1241
Mailing Address - Fax:586-806-6437
Practice Address - Street 1:27200 PARKVIEW BLVD
Practice Address - Street 2:SUITE #208
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-2884
Practice Address - Country:US
Practice Address - Phone:313-980-1241
Practice Address - Fax:586-806-6437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2446343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)