Organization
CITY CAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHNOSCAR LACY (OWNER)
(870) 780-6692
Entity
Organization
Contact information
Practice address
619 W MOULTRIE DR, BLYTHEVILLE, AR 72315-1936
(870) 780-6692
(870) 780-6693
Mailing address
619 W MOULTRIE DR, BLYTHEVILLE, AR 72315-1936
(870) 780-6692
(870) 780-6693
Taxonomy
Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
05/09/2016
Last updated
05/09/2016
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