MEDICARE: OREGON COAST TRANSPORTERS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)
2	343800000X	Secured Medical Transport (VAN)

General Provider Information

NPI Number	:	1588937106
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OREGON COAST TRANSPORTERS, LLC

Provider Business Mailing Address
First Line	:	PO BOX 528
Second Line	:
City	:	NEWPORT
State	:	OR
Zip	:	97365-0037
Country	:	US
Telephone Number	:	541-265-8964
Fax Number	:

Provider Business Practice Location Address
First Line	:	2329 NE VALLEY RIDGE DR
Second Line	:
City	:	NEWPORT
State	:	OR
Zip	:	97365-9565
Country	:	US
Telephone Number	:	541-265-8964
Fax Number	:

Authorized Official
Title or Position	:	SOLE MBR
Name	:	MRS. SUE K JONES
Credential	:
Telephone Number	:	541-265-8964

Provider Enumeration Date	:	02/13/2012
Last Update Date	:	06/13/2014

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