Healthcare Provider Details

I. General information

NPI: 1407016066
Provider Name (Legal Business Name): CASCADE MEDICAL TRANSPORTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 NE MEDICAL CENTER DR
BEND OR
97701-6051
US

IV. Provider business mailing address

1123 NW BOND ST
BEND OR
97701-1901
US

V. Phone/Fax

Practice location:
  • Phone: 541-419-7531
  • Fax: 541-322-3512
Mailing address:
  • Phone: 541-419-7531
  • Fax: 541-322-3512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: LAURIE RAE SIMPSON
Title or Position: DIRECTOR
Credential:
Phone: 541-419-7531