Healthcare Provider Details

I. General information

NPI: 1528691979
Provider Name (Legal Business Name): RED SHIELD TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2020
Last Update Date: 03/25/2020
Certification Date: 03/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 LINCOLN AVE
ROCHESTER NY
14611-2444
US

IV. Provider business mailing address

56 ELLISON ST
ROCHESTER NY
14609-4741
US

V. Phone/Fax

Practice location:
  • Phone: 585-435-9661
  • Fax:
Mailing address:
  • Phone: 585-435-9661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JERMAINE GRIMES
Title or Position: OWNER
Credential:
Phone: 585-435-9661