Provider Demographics
NPI:1114131554
Name:MEDALERT MEDICAL TRANSPORT
Entity Type:Organization
Organization Name:MEDALERT MEDICAL TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:HEMILLO
Authorized Official - Middle Name:R
Authorized Official - Last Name:DELIMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-568-5859
Mailing Address - Street 1:1204 RIVERA DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95838-4446
Mailing Address - Country:US
Mailing Address - Phone:916-568-5859
Mailing Address - Fax:916-564-2008
Practice Address - Street 1:1204 RIVERA DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95838-4446
Practice Address - Country:US
Practice Address - Phone:916-568-5859
Practice Address - Fax:916-564-2008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA135781343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)