Healthcare Provider Details

I. General information

NPI: 1164747770
Provider Name (Legal Business Name): MOUNTAIN WEST NON-EMERGENCY MEDICAL TRANSPORTATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2010
Last Update Date: 04/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 COGNAC CIR
SACRAMENTO CA
95835-2035
US

IV. Provider business mailing address

151 COGNAC CIR
SACRAMENTO CA
95835-2035
US

V. Phone/Fax

Practice location:
  • Phone: 916-996-3002
  • Fax: 916-419-9516
Mailing address:
  • Phone: 916-996-3002
  • Fax: 916-419-9516

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: MR. BARRETT SCHREIBER
Title or Position: PRESIDENT
Credential:
Phone: 916-996-3002