Provider Demographics
NPI:1699533851
Name:GOLD MOUNTAIN TRANSPORT LLC
Entity type:Organization
Organization Name:GOLD MOUNTAIN TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RAMASES
Authorized Official - Middle Name:
Authorized Official - Last Name:GOUSHEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-485-5113
Mailing Address - Street 1:3875 TAYLOR RD STE K
Mailing Address - Street 2:
Mailing Address - City:LOOMIS
Mailing Address - State:CA
Mailing Address - Zip Code:95650-9272
Mailing Address - Country:US
Mailing Address - Phone:530-485-5113
Mailing Address - Fax:
Practice Address - Street 1:3875 TAYLOR RD STE K
Practice Address - Street 2:
Practice Address - City:LOOMIS
Practice Address - State:CA
Practice Address - Zip Code:95650-9272
Practice Address - Country:US
Practice Address - Phone:530-485-5113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)