Healthcare Provider Details

I. General information

NPI: 1235876343
Provider Name (Legal Business Name): YELLOW CAB MEDICAL TRANSPORT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2022
Last Update Date: 05/19/2022
Certification Date: 05/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 FISHER RD NE
SALEM OR
97305-1238
US

IV. Provider business mailing address

2425 FISHER RD NE
SALEM OR
97305-1238
US

V. Phone/Fax

Practice location:
  • Phone: 503-763-7327
  • Fax: 503-362-6446
Mailing address:
  • Phone: 503-763-7327
  • Fax: 503-362-6446

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: ERIN ANN WAKEFIELD
Title or Position: PRESIDENT
Credential:
Phone: 503-763-7327