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General NPI Number Information
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NPI Number | 1891234787
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Entity Type | Organization
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Legal Business Name | FAITHFUL MEDICAL TRANSPORT SERVICES LLC
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Dates
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Enumeration Date | 02/13/2017
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Last Update Date | 04/28/2017
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Provider Practice Location Address
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Address Line | 17777 CENTER COURT DRIVE SUITE 600
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City | CERRITOS
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State | CA
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Zip | 90703
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Country | US
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Telephone | 562-714-0488
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Fax | 714-752-6083
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Provider Business Mailing Address
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Address Line | 18173 PIONEER BLVD STE C
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City | ARTESIA
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State | CA
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Zip | 90701-3982
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Country | US
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Telephone | 562-860-8800
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Fax | 562-366-3011
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Authorized Official
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Title or Position | OWNER
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Name | MR. KRIS JOHNSON
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Credential |
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Telephone | 562-714-1063
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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 | 201703210371
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License Number State | CA
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