Healthcare Provider Details

I. General information

NPI: 1417425588
Provider Name (Legal Business Name): INSPIRATION TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2018
Last Update Date: 11/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3480 W BLUFF AVE
FRESNO CA
93711-0105
US

IV. Provider business mailing address

7081 N MARKS AVE STE 104, PMB 195
FRESNO CA
93711
US

V. Phone/Fax

Practice location:
  • Phone: 559-578-3848
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW GILLIAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 559-578-3848