Healthcare Provider Details

I. General information

NPI: 1528098431
Provider Name (Legal Business Name): DESERT CRITICAL CARE TRANSPORT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 N. BROADWAY DR.
BLYTHE CA
92225
US

IV. Provider business mailing address

PO BOX 796
BLYTHE CA
92226-0796
US

V. Phone/Fax

Practice location:
  • Phone: 760-922-5911
  • Fax: 760-922-5912
Mailing address:
  • Phone: 760-922-5911
  • Fax: 760-922-5912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1897
License Number StateCA

VIII. Authorized Official

Name: MS. TRINA RENEE DAVIS-SARTIN
Title or Position: PREISIDENT
Credential:
Phone: 760-922-5911