Provider Demographics
NPI:1225165160
Name:SPECIAL CARE TRANSPORT INC
Entity Type:Organization
Organization Name:SPECIAL CARE TRANSPORT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:HARRY
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-746-6779
Mailing Address - Street 1:3320 INDUSTRIAL AVENUE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97478-5647
Mailing Address - Country:US
Mailing Address - Phone:541-746-6779
Mailing Address - Fax:541-746-6769
Practice Address - Street 1:3320 INDUSTRIAL AVENUE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97478-5647
Practice Address - Country:US
Practice Address - Phone:541-746-6779
Practice Address - Fax:541-746-6769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR181086Medicaid