Provider Demographics
NPI:1598314056
Name:MEDIGO TRANSIT NEMT INC
Entity type:Organization
Organization Name:MEDIGO TRANSIT NEMT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LUTHER
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:CRUMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-362-1428
Mailing Address - Street 1:1030 W ITUNI ST
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-4056
Mailing Address - Country:US
Mailing Address - Phone:626-362-1428
Mailing Address - Fax:626-856-1757
Practice Address - Street 1:1030 W ITUNI ST
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-4056
Practice Address - Country:US
Practice Address - Phone:626-362-1428
Practice Address - Fax:626-856-1757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-08
Last Update Date:2019-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)