Healthcare Provider Details

I. General information

NPI: 1679313829
Provider Name (Legal Business Name): PATIENT MEDICAL TRANSPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2024
Last Update Date: 06/19/2024
Certification Date: 06/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 CAPPALAPPA AVE
LOGANDALE NV
89021-0269
US

IV. Provider business mailing address

PO BOX 1028
LOGANDALE NV
89021-1028
US

V. Phone/Fax

Practice location:
  • Phone: 702-250-8881
  • Fax: 775-344-9592
Mailing address:
  • Phone: 702-250-8881
  • Fax: 775-344-9592

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: WENDY A SKINNER
Title or Position: MANAGER
Credential: MANAGING MEMBER
Phone: 702-250-8881