Healthcare Provider Details

I. General information

NPI: 1558069765
Provider Name (Legal Business Name): PHOENIX TRANSPORTATION SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2023
Last Update Date: 02/16/2023
Certification Date: 02/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3208 STINE RD
BAKERSFIELD CA
93309-6354
US

IV. Provider business mailing address

3208 STINE RD
BAKERSFIELD CA
93309-6354
US

V. Phone/Fax

Practice location:
  • Phone: 661-717-9556
  • Fax:
Mailing address:
  • Phone: 661-717-9556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: NANCY CASTEEL
Title or Position: OWNER
Credential: RCP
Phone: 661-717-9556