Healthcare Provider Details

I. General information

NPI: 1649409038
Provider Name (Legal Business Name): PURITY TRANSPORTATION COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2009
Last Update Date: 07/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2138 218TH PL
SAUK VILLAGE IL
60411-5014
US

IV. Provider business mailing address

2138 218TH PL
SAUK VILLAGE IL
60411-5014
US

V. Phone/Fax

Practice location:
  • Phone: 708-543-4889
  • Fax:
Mailing address:
  • Phone: 708-543-4889
  • 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: LAURIEL YAMINI
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 708-543-4889