Healthcare Provider Details

I. General information

NPI: 1104008044
Provider Name (Legal Business Name): A-C TRANSPORTATION SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2007
Last Update Date: 12/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1243 LOTUS CT
SANTA ROSA CA
95404-5918
US

IV. Provider business mailing address

1243 LOTUS CT
SANTA ROSA CA
95404-5918
US

V. Phone/Fax

Practice location:
  • Phone: 707-636-0805
  • Fax:
Mailing address:
  • Phone: 707-636-0805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License NumberN7211004
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberN7211004
License Number StateCA

VIII. Authorized Official

Name: MR. KEVIN TAY KROH
Title or Position: PRESIDENT
Credential:
Phone: 707-636-0805