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General NPI Number Information
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NPI Number | 1780139568
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Entity Type | Organization
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Legal Business Name | SHAW PEARSON TRANSPORT LLC
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Dates
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Enumeration Date | 08/22/2016
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Last Update Date | 08/27/2016
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Provider Practice Location Address
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Address Line | 11150 ADDISON ST
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City | ADELANTO
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State | CA
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Zip | 92301-4616
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Country | US
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Telephone | 760-530-7590
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Fax | 760-530-7591
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Provider Business Mailing Address
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Address Line | P.O BOX 1238
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City | ADELANTO
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State | CA
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Zip | 92301
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Country | US
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Telephone | 760-530-7590
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Fax | 760-530-7591
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Authorized Official
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Title or Position | PRESIDENT
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Name | TONI SHAW
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Credential |
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Telephone | 760-530-7590
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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 | 00405356
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License Number State | CA
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