Provider Demographics
NPI:1346076171
Name:BETHEL TRANSPORT SERVICES
Entity type:Organization
Organization Name:BETHEL TRANSPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNA
Authorized Official - Prefix:
Authorized Official - First Name:CHUKWUMA
Authorized Official - Middle Name:EMMANUEL
Authorized Official - Last Name:IGWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-356-4350
Mailing Address - Street 1:14148 CALLE DOMINGO
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92392-5452
Mailing Address - Country:US
Mailing Address - Phone:424-356-4350
Mailing Address - Fax:
Practice Address - Street 1:14148 CALLE DOMINGO
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-5452
Practice Address - Country:US
Practice Address - Phone:424-356-4350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)