=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780991620
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SARASOTA COUNTY TRANSPORTATION AUTHORITY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/13/2010
-----------------------------------------------------
Last Update Date | 09/13/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5303 PINKNEY AVE
-----------------------------------------------------
City | SARASOTA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34233-2421
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-861-1234
-----------------------------------------------------
Fax | 941-861-1000
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5303 PINKNEY AVE
-----------------------------------------------------
City | SARASOTA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34233-2421
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-861-1234
-----------------------------------------------------
Fax | 941-861-1000
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BUSINESS PROFESSIONAL
-----------------------------------------------------
Name | MR. JASON HARRIS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 941-861-1048
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------