Healthcare Provider Details

I. General information

NPI: 1992492706
Provider Name (Legal Business Name): OPERATION LIFE NON EMERGENCY MEDICAL TRANSPORT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2023
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

577 N D ST STE 115
SAN BERNARDINO CA
92401-1326
US

IV. Provider business mailing address

577 N D ST STE 115
SAN BERNARDINO CA
92401-1326
US

V. Phone/Fax

Practice location:
  • Phone: 909-838-7975
  • Fax:
Mailing address:
  • Phone: 909-893-0391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: STEPHANIE R SANCHEZ
Title or Position: MANAGER
Credential:
Phone: 909-838-7975