Provider Demographics
NPI:1528246659
Name:RIVERSIDE ACTION MEDICAL TRANSPORTATION
Entity type:Organization
Organization Name:RIVERSIDE ACTION MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AGNES
Authorized Official - Middle Name:
Authorized Official - Last Name:ZORILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-533-9131
Mailing Address - Street 1:24250 POSTAL AVE STE 201-1
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-7722
Mailing Address - Country:US
Mailing Address - Phone:951-485-7800
Mailing Address - Fax:
Practice Address - Street 1:24250 POSTAL AVE STE 201-1
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-7722
Practice Address - Country:US
Practice Address - Phone:951-485-7800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)