Healthcare Provider Details

I. General information

NPI: 1710025309
Provider Name (Legal Business Name): J & R SECURE TRANSPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43776 BUCKBOARD TRAIL RD
PENDLETON OR
97801-9315
US

IV. Provider business mailing address

PO BOX 592
PENDLETON OR
97801-0592
US

V. Phone/Fax

Practice location:
  • Phone: 866-676-0936
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number StateOR

VIII. Authorized Official

Name: JIM HEALEY
Title or Position: PARTNER
Credential:
Phone: 541-566-0907