Healthcare Provider Details
I. General information
NPI: 1164429809
Provider Name (Legal Business Name): GOLDEN TRANSPORT LTD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/07/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
219 N BROADWAY AVE STE B
ELSA TX
78543
US
IV. Provider business mailing address
PO BOX 1284
WESLACO TX
78599-1284
US
V. Phone/Fax
- Phone: 956-262-7877
- Fax: 956-968-5928
- Phone: 956-262-7877
- Fax: 956-968-5928
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | 108054 |
| License Number State | TX |
VIII. Authorized Official
Name: MR.
FRANCISCO
J
OLIVA
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 956-472-4064