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General NPI Number Information
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NPI Number | 1659543163
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Entity Type | Organization
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Legal Business Name | CONEJOMEDTRANS,INC
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Dates
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Enumeration Date | 03/25/2008
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Last Update Date | 03/25/2008
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Provider Practice Location Address
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Address Line | 190 E HILLCREST DR
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-5839
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Country | US
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Telephone | 805-494-9080
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Fax | 805-373-3952
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Provider Business Mailing Address
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Address Line | 190 E HILLCREST DR
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-5839
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Country | US
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Telephone | 805-494-9080
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Fax | 805-373-3952
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Authorized Official
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Title or Position | CORPORATE SECRETARY/TREASURER
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Name | MRS. GILLIANA SHERMAN
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Credential |
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Telephone | 805-558-6868
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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 | 2782676
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License Number State | CA
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