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General NPI Number Information
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NPI Number | 1134424526
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Entity Type | Organization
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Legal Business Name | MIDAS MEDICAL TRANSPORTATION, LLC
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Dates
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Enumeration Date | 01/18/2011
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Last Update Date | 01/18/2011
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Provider Practice Location Address
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Address Line | 19244 LAURENRAE ST
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City | RIVERSIDE
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State | CA
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Zip | 92508-6238
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Country | US
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Telephone | 951-858-7206
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Fax | 951-565-8009
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Provider Business Mailing Address
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Address Line | 19244 LAURENRAE ST
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City | RIVERSIDE
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State | CA
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Zip | 92508-6238
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Country | US
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Telephone | 951-858-7206
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Fax | 951-565-8009
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Authorized Official
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Title or Position | CEO
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Name | MR. LINDON LEACH
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Credential |
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Telephone | 951-858-7206
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 201036510025
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License Number State | CA
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