Healthcare Provider Details

I. General information

NPI: 1992246318
Provider Name (Legal Business Name): WHEELS OF HOPE MEDICAL TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2017
Last Update Date: 03/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2895 NE 47TH ST APT #D1
LINCOLN CITY OR
97367-5245
US

IV. Provider business mailing address

PO BOX 351
LINCOLN CITY OR
97367-0351
US

V. Phone/Fax

Practice location:
  • Phone: 559-740-8587
  • Fax:
Mailing address:
  • Phone: 559-740-8587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MRS. ROBIN LEA JARRETT FRAZIER
Title or Position: OWNER / MEDICAL TRANSPORTATION
Credential:
Phone: 559-740-8587