Provider Demographics
NPI:1164487211
Name:ROCHESTER MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:ROCHESTER MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:ARON
Authorized Official - Middle Name:
Authorized Official - Last Name:YEFRAIMOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-288-3444
Mailing Address - Street 1:2140 EAST MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609
Mailing Address - Country:US
Mailing Address - Phone:585-288-3444
Mailing Address - Fax:585-654-9543
Practice Address - Street 1:2140 EAST MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609
Practice Address - Country:US
Practice Address - Phone:585-288-3444
Practice Address - Fax:585-654-9543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY34662343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02240462Medicaid
NY113440FXOtherPREFERRED CARE