Healthcare Provider Details

I. General information

NPI: 1346516614
Provider Name (Legal Business Name): BLS NON-EMERGENT MEDICAL TRANSPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2012
Last Update Date: 03/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4735 BEACON RD
PASO ROBLES CA
93446
US

IV. Provider business mailing address

PO BOX 899
PASO ROBLES CA
93447-0899
US

V. Phone/Fax

Practice location:
  • Phone: 805-226-7308
  • Fax:
Mailing address:
  • Phone: 805-226-7308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number0732909
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number0732909
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number0732909
License Number StateCA

VIII. Authorized Official

Name: BRANDON LAWRENCE SIMMONS
Title or Position: OWNER/OPERATOR
Credential: EMT
Phone: 805-226-7308