Provider Demographics
NPI:1194004564
Name:SENIOR CARE BY RN'S TRANSPORTATION SERVICE
Entity Type:Organization
Organization Name:SENIOR CARE BY RN'S TRANSPORTATION SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-416-1378
Mailing Address - Street 1:224 LIVE OAK CIR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-6801
Mailing Address - Country:US
Mailing Address - Phone:916-416-1378
Mailing Address - Fax:
Practice Address - Street 1:224 LIVE OAK CIR
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-6801
Practice Address - Country:US
Practice Address - Phone:916-416-1378
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-16
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)