Healthcare Provider Details

I. General information

NPI: 1114892130
Provider Name (Legal Business Name): JBS TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14219 OAK KNOLL RD
SONORA CA
95370-8822
US

IV. Provider business mailing address

14219 OAK KNOLL RD
SONORA CA
95370-8822
US

V. Phone/Fax

Practice location:
  • Phone: 209-596-1605
  • Fax:
Mailing address:
  • Phone: 209-596-1605
  • Fax:

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: SCOTT PEPITO
Title or Position: MANAGER
Credential:
Phone: 209-596-1605