Organization
SAFEWAY MEDICAR
Active
Parent organization
D11127417
Other names
N/A
Organization subpart
Yes
Provider details
NPI number
Legal business name
D11127417
Authorized official
MR. EDMUNDO JR. HECHANOVA CORTEZ JR. (MANAGER/OWMER)
(773) 458-9020
Entity
Organization
Contact information
Practice address
4915 N MONTICELLO AVE, CHICAGO, IL 60625-5653
(773) 458-9020
Mailing address
4915 NORTH MONTICELLO AVE., CHICAGO, IL 60625
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
10/10/2011
Last updated
10/10/2011
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