Healthcare Provider Details

I. General information

NPI: 1225165160
Provider Name (Legal Business Name): SPECIAL CARE TRANSPORT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3320 INDUSTRIAL AVENUE
SPRINGFIELD OR
97478-5647
US

IV. Provider business mailing address

3320 INDUSTRIAL AVENUE
SPRINGFIELD OR
97478-5647
US

V. Phone/Fax

Practice location:
  • Phone: 541-746-6779
  • Fax: 541-746-6769
Mailing address:
  • Phone: 541-746-6779
  • Fax: 541-746-6769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. CHRISTOPHER HARRY SMITH
Title or Position: CO OWNER MANAGER
Credential:
Phone: 541-746-6779