Organization
MAC LIMOUSINE SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK DAMON MCCOLLUM (CEO)
(773) 746-1399
Entity
Organization
Contact information
Practice address
347 S CICERO AVE, CHICAGO, IL 60644-4905
(773) 746-1399
(773) 626-2118
Mailing address
347 S CICERO AVE, CHICAGO, IL 60644-4905
(773) 746-1399
(773) 626-2118
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
Other
Enumeration date
01/05/2023
Last updated
01/19/2023
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