Provider Demographics
NPI:1073936241
Name:ACCESS MEDICAL TRANSPORT
Entity Type:Organization
Organization Name:ACCESS MEDICAL TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WELLA
Authorized Official - Middle Name:M
Authorized Official - Last Name:VAN UNEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:671-646-6970
Mailing Address - Street 1:PO BOX 6948
Mailing Address - Street 2:
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96931-6948
Mailing Address - Country:US
Mailing Address - Phone:671-646-6970
Mailing Address - Fax:671-646-6971
Practice Address - Street 1:17-3404 NEPTUNE AVE STE 202
Practice Address - Street 2:
Practice Address - City:BARRIGADA
Practice Address - State:GU
Practice Address - Zip Code:96913-1600
Practice Address - Country:US
Practice Address - Phone:671-646-6970
Practice Address - Fax:671-646-6971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-23
Last Update Date:2024-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GU3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport