Provider Demographics
NPI:1750071882
Name:MACOMBS TRANSPORTATION CORP
Entity type:Organization
Organization Name:MACOMBS TRANSPORTATION CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:E
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:646-249-2381
Mailing Address - Street 1:695 E 132ND ST # 1C
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10454-3434
Mailing Address - Country:US
Mailing Address - Phone:646-249-2381
Mailing Address - Fax:
Practice Address - Street 1:695 E 132ND ST, BRONX, NY 10454
Practice Address - Street 2:1C
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-1045
Practice Address - Country:US
Practice Address - Phone:646-249-2381
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)