Provider Demographics
NPI:1134302664
Name:PREFERRED NON-EMERGENCY TRANSPORT
Entity Type:Organization
Organization Name:PREFERRED NON-EMERGENCY TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:PALACIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-244-4559
Mailing Address - Street 1:15847 ASH ST
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-4258
Mailing Address - Country:US
Mailing Address - Phone:760-244-4559
Mailing Address - Fax:
Practice Address - Street 1:15847 ASH ST
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-4258
Practice Address - Country:US
Practice Address - Phone:760-244-4559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)