Provider Demographics
NPI:1053771022
Name:BIGNON MEDICAL TRANSPORTATION LLC
Entity type:Organization
Organization Name:BIGNON MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACT MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BIGNON
Authorized Official - Middle Name:
Authorized Official - Last Name:DOMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-455-1081
Mailing Address - Street 1:120 MIDDLE ST # 719
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06602
Mailing Address - Country:US
Mailing Address - Phone:203-455-1081
Mailing Address - Fax:203-290-5760
Practice Address - Street 1:120 MIDDLE ST # 719
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06602-9998
Practice Address - Country:US
Practice Address - Phone:203-455-1081
Practice Address - Fax:203-290-5760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT040787542343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)