Provider Demographics
NPI:1093278517
Name:ST. MARK & ARCH ANGEL MICHAEL INC.
Entity Type:Organization
Organization Name:ST. MARK & ARCH ANGEL MICHAEL INC.
Other - Org Name:SAFETY 1ST MEDICAL TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AYREEN
Authorized Official - Middle Name:I
Authorized Official - Last Name:SONBOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-796-0112
Mailing Address - Street 1:2145 RAMBLING ROSE DR
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-2533
Mailing Address - Country:US
Mailing Address - Phone:805-504-7470
Mailing Address - Fax:
Practice Address - Street 1:2145 RAMBLING ROSE DR
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-2533
Practice Address - Country:US
Practice Address - Phone:805-504-7470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-11
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)