Healthcare Provider Details

I. General information

NPI: 1003279241
Provider Name (Legal Business Name): ONTIME TECH COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2016
Last Update Date: 04/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2391 ARDEN WAY STE 3
SACRAMENTO CA
95825-4030
US

IV. Provider business mailing address

2391 ARDEN WAY STE 3
SACRAMENTO CA
95825-4030
US

V. Phone/Fax

Practice location:
  • Phone: 916-568-9384
  • Fax:
Mailing address:
  • Phone: 916-568-9384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: MR. ASWAD OMAR RASHID FAUNTLEROY
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 916-544-0573