Organization
MVP MEDICAL TRANSIT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARDELL JACKSON (AO)
(386) 697-9425
Entity
Organization
Contact information
Practice address
197 NW GWEN LAKE AVE, LAKE CITY, FL 32055-3711
(386) 466-9464
Mailing address
PO BOX 2666, LAKE CITY, FL 32056-2666
(386) 697-9425
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
08/08/2022
Last updated
08/08/2022
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