Provider Demographics
NPI:1083470785
Name:DORIAN MEDICAL TRANSPORT INC
Entity Type:Organization
Organization Name:DORIAN MEDICAL TRANSPORT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:A
Authorized Official - Last Name:EMETOH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-549-3045
Mailing Address - Street 1:2069 SAN BERNARDINO AVENUE
Mailing Address - Street 2:APT 1183
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324
Mailing Address - Country:US
Mailing Address - Phone:909-549-3045
Mailing Address - Fax:
Practice Address - Street 1:2069 SAN BERNARDINO AVENUE
Practice Address - Street 2:APT 1183
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324
Practice Address - Country:US
Practice Address - Phone:909-549-3045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)