Healthcare Provider Details

I. General information

NPI: 1053932772
Provider Name (Legal Business Name): N.E.M.T BY MOE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2020
Last Update Date: 06/11/2023
Certification Date: 06/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39195 ETERNITY LN
MURRIETA CA
92563-6873
US

IV. Provider business mailing address

PO BOX 444 30724 BENTON RD STE C302
WINCHESTER CA
92596-8470
US

V. Phone/Fax

Practice location:
  • Phone: 951-260-8909
  • Fax:
Mailing address:
  • Phone: 951-260-8909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
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: MRS. MONIQUE PATRISE MURRAY CARTER
Title or Position: OWNER/OPERATOR
Credential:
Phone: 951-260-8909