Provider Demographics
NPI:1154786408
Name:AMDAL TRANSPORT SERVICES
Entity type:Organization
Organization Name:AMDAL TRANSPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN-SOARES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:559-686-6611
Mailing Address - Street 1:318 S M ST
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-5429
Mailing Address - Country:US
Mailing Address - Phone:559-686-6611
Mailing Address - Fax:559-686-6622
Practice Address - Street 1:8315 MORRO RD STE 101
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-3949
Practice Address - Country:US
Practice Address - Phone:805-464-0108
Practice Address - Fax:805-464-0157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)