=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891553582
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REGINAL CONSULTING AND MANAGEMENT L.L.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/07/2024
-----------------------------------------------------
Last Update Date | 03/07/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6130 FREEPORT BLVD STE 100F
-----------------------------------------------------
City | SACRAMENTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95822-3520
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-548-1537
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6130 FREEPORT BLVD STE 100F
-----------------------------------------------------
City | SACRAMENTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95822-3520
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-548-1537
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DEITORE R COATES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 916-548-1537
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------