Provider Demographics
NPI:1528502382
Name:ZOOM MEDICAL TRANSPORTATION 001 LLC
Entity type:Organization
Organization Name:ZOOM MEDICAL TRANSPORTATION 001 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:HURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-617-1525
Mailing Address - Street 1:12915 ROSELLE AVE
Mailing Address - Street 2:#2
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-5366
Mailing Address - Country:US
Mailing Address - Phone:310-617-1525
Mailing Address - Fax:
Practice Address - Street 1:12915 ROSELLE AVE
Practice Address - Street 2:#2
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-5366
Practice Address - Country:US
Practice Address - Phone:310-617-1525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-14
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)