Healthcare Provider Details

I. General information

NPI: 1639618572
Provider Name (Legal Business Name): DIGNITY CARE MEDICAL TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2017
Last Update Date: 02/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7230 SAOUTH LAND PARK DRIVE SUITE 101
SACRAMENTO CA
95831
US

IV. Provider business mailing address

7230 SAOUTH LAND PARK DRIVE SUITE 101
SACRAMENTO CA
95831
US

V. Phone/Fax

Practice location:
  • Phone: 916-956-3782
  • Fax:
Mailing address:
  • Phone: 916-956-3782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES ANTWI
Title or Position: CEO
Credential:
Phone: 916-956-3782