Provider Demographics
NPI:1326887365
Name:SUBLIME MEDICAL TRANSPORT LLC
Entity type:Organization
Organization Name:SUBLIME MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS DEVELOPMENT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MUNASHE
Authorized Official - Middle Name:DAVIES
Authorized Official - Last Name:GUMBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-706-8712
Mailing Address - Street 1:2277 PEREZ ST APT 240
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-1769
Mailing Address - Country:US
Mailing Address - Phone:831-256-5882
Mailing Address - Fax:
Practice Address - Street 1:220 AMORE CT UNIT 240
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:CA
Practice Address - Zip Code:93926-2728
Practice Address - Country:US
Practice Address - Phone:831-256-5882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)