MEDICARE: RIDGECREST MEDICAL TRANSPORT CORPORATION

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)

General Provider Information

NPI Number	:	1811822380
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIDGECREST MEDICAL TRANSPORT CORPORATION

Provider Business Mailing Address
First Line	:	1201 W RIDGECREST BLVD
Second Line	:
City	:	RIDGECREST
State	:	CA
Zip	:	93555-5429
Country	:	US
Telephone Number	:	760-495-2394
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 W RIDGECREST BLVD
Second Line	:
City	:	RIDGECREST
State	:	CA
Zip	:	93555-5429
Country	:	US
Telephone Number	:	760-495-2394
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	SAMUEL JARVIS MILES
Credential	:
Telephone Number	:	760-608-2840

Provider Enumeration Date	:	06/16/2026
Last Update Date	:	06/16/2026

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