Provider Demographics
NPI:1114276359
Name:BADLY SCATTERED LAND AND CATTLE
Entity Type:Organization
Organization Name:BADLY SCATTERED LAND AND CATTLE
Other - Org Name:MEDIC COACH SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:TEMPLETON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-296-4158
Mailing Address - Street 1:6120 FELDMAN ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-3413
Mailing Address - Country:US
Mailing Address - Phone:702-296-4158
Mailing Address - Fax:
Practice Address - Street 1:1110 S 3RD ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-1005
Practice Address - Country:US
Practice Address - Phone:702-454-6176
Practice Address - Fax:702-382-5668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-04
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV19821004792343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)