Provider Demographics
NPI:1699049098
Name:M3 TRANSPORTATION
Entity type:Organization
Organization Name:M3 TRANSPORTATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:E
Authorized Official - Last Name:MAILE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-259-8070
Mailing Address - Street 1:91 ALGONQUIN ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02302-2452
Mailing Address - Country:US
Mailing Address - Phone:774-259-8070
Mailing Address - Fax:508-584-9696
Practice Address - Street 1:91 ALGONQUIN ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-2452
Practice Address - Country:US
Practice Address - Phone:774-259-8070
Practice Address - Fax:508-584-9696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-02
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle