Healthcare Provider Details

I. General information

NPI: 1073936241
Provider Name (Legal Business Name): ACCESS MEDICAL TRANSPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2014
Last Update Date: 09/25/2024
Certification Date: 09/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 EDWARD T CALVO MEMORIAL PARKWAY UNIT 101
TAMUNING GU
96913-0000
US

IV. Provider business mailing address

PO BOX 6948
TAMUNING GU
96931-6948
US

V. Phone/Fax

Practice location:
  • Phone: 671-646-6970
  • Fax: 671-646-6971
Mailing address:
  • Phone: 671-646-6970
  • Fax: 671-646-6971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number StateGU

VIII. Authorized Official

Name: WELLA GHIN ALEXIS VAN UNEN
Title or Position: PRESIDENT
Credential:
Phone: 671-646-6970