Healthcare Provider Details

I. General information

NPI: 1144167966
Provider Name (Legal Business Name): SOUTH LANE WHEELS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 BIRCH AVE
COTTAGE GROVE OR
97424-1417
US

IV. Provider business mailing address

1450 BIRCH AVE
COTTAGE GROVE OR
97424-1417
US

V. Phone/Fax

Practice location:
  • Phone: 541-942-0456
  • Fax: 541-942-9691
Mailing address:
  • Phone: 541-942-0456
  • Fax: 541-942-9691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: MRS. RUTH ELAINE LINOZ
Title or Position: EXECUTIVE DIRECTOR
Credential: LINOZ
Phone: 541-942-0456