Healthcare Provider Details

I. General information

NPI: 1417554643
Provider Name (Legal Business Name): METHODIST TRAINING & OUTREACH CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2020
Last Update Date: 10/01/2020
Certification Date: 09/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4A KRONPRINDSENS GADE
ST. THOMAS VI
00802-6451
US

IV. Provider business mailing address

PO BOX 306816
ST THOMAS VI
00803-6816
US

V. Phone/Fax

Practice location:
  • Phone: 340-714-7782
  • Fax:
Mailing address:
  • Phone: 340-714-7782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. ERMA C DERIMA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 340-714-7782