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General NPI Number Information
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NPI Number | 1245781376
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Entity Type | Organization
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Legal Business Name | HEART OF GOLD MEDICAL TRANSPORT, INC.
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Dates
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Enumeration Date | 10/24/2016
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Last Update Date | 02/09/2018
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Provider Practice Location Address
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Address Line | 1329 HOWE AVE STE 205
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City | SACRAMENTO
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State | CA
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Zip | 95825-3363
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Country | US
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Telephone | 916-740-6447
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7862
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City | CITRUS HEIGHTS
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State | CA
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Zip | 95621-7862
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MEGAN MARIE PAGAN
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Credential | RN
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Telephone | 916-740-6447
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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 |
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License Number State |
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