Provider Demographics
NPI:1407685902
Name:EM MEDICAL TRANSPORT LLC
Entity type:Organization
Organization Name:EM MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:GUADALUPE
Authorized Official - Last Name:MONTEJANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-783-3606
Mailing Address - Street 1:1300 RAMONA CT
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:CA
Mailing Address - Zip Code:92251-8602
Mailing Address - Country:US
Mailing Address - Phone:760-783-3606
Mailing Address - Fax:
Practice Address - Street 1:1300 RAMONA CT
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:CA
Practice Address - Zip Code:92251-8602
Practice Address - Country:US
Practice Address - Phone:760-783-3606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)