Provider Demographics
NPI:1124451125
Name:ONSITE MEDITRANSPORT
Entity type:Organization
Organization Name:ONSITE MEDITRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:HURTADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-715-1250
Mailing Address - Street 1:5630 LYONS ST
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-1546
Mailing Address - Country:US
Mailing Address - Phone:708-937-8125
Mailing Address - Fax:847-674-0892
Practice Address - Street 1:5630 LYONS ST
Practice Address - Street 2:
Practice Address - City:MORTON GROVE
Practice Address - State:IL
Practice Address - Zip Code:60053-1546
Practice Address - Country:US
Practice Address - Phone:708-937-8125
Practice Address - Fax:847-674-0892
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ONSITE HEALTH ANCILLARY SERVICES,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)