Healthcare Provider Details

I. General information

NPI: 1811822380
Provider Name (Legal Business Name): RIDGECREST MEDICAL TRANSPORT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 W RIDGECREST BLVD
RIDGECREST CA
93555-5429
US

IV. Provider business mailing address

1201 W RIDGECREST BLVD
RIDGECREST CA
93555-5429
US

V. Phone/Fax

Practice location:
  • Phone: 760-495-2394
  • Fax:
Mailing address:
  • Phone: 760-495-2394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: SAMUEL JARVIS MILES
Title or Position: CO-OWNER
Credential:
Phone: 760-608-2840