Provider Demographics
NPI:1366762882
Name:MED-TECH NON EMERGENT
Entity type:Organization
Organization Name:MED-TECH NON EMERGENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:RHOAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-805-4825
Mailing Address - Street 1:1981 ISLA DE PALMA CIR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-3403
Mailing Address - Country:US
Mailing Address - Phone:239-455-5231
Mailing Address - Fax:
Practice Address - Street 1:1981 ISLA DE PALMA CIR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-3403
Practice Address - Country:US
Practice Address - Phone:239-455-5231
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP07000034996343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)