Provider Demographics
NPI:1992416705
Name:BLUEPRINT MEDICAL TRANSPORT
Entity type:Organization
Organization Name:BLUEPRINT MEDICAL TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-380-1007
Mailing Address - Street 1:398 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07017-2573
Mailing Address - Country:US
Mailing Address - Phone:973-380-1007
Mailing Address - Fax:973-513-6112
Practice Address - Street 1:398 PARK AVE
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07017-2573
Practice Address - Country:US
Practice Address - Phone:973-380-1007
Practice Address - Fax:973-513-6112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No342000000XTransportation ServicesTransportation Network Company