Provider Demographics
NPI:1427474576
Name:SJM TRANSPORT
Entity type:Organization
Organization Name:SJM TRANSPORT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:PERPIGNAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-388-8305
Mailing Address - Street 1:94801 FARRINGTON HWY SUITE 204
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797
Mailing Address - Country:US
Mailing Address - Phone:808-388-8305
Mailing Address - Fax:808-678-3325
Practice Address - Street 1:634 KILANI AVENUE
Practice Address - Street 2:
Practice Address - City:WAHIAWA
Practice Address - State:HAWAII
Practice Address - Zip Code:96786
Practice Address - Country:UM
Practice Address - Phone:808-388-8305
Practice Address - Fax:808-678-3325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)