Provider Demographics
NPI:1235808296
Name:SERENITY MEDICAL TRANSPORT
Entity Type:Organization
Organization Name:SERENITY MEDICAL TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KANWALJIT
Authorized Official - Middle Name:S
Authorized Official - Last Name:ANAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-243-3666
Mailing Address - Street 1:7801 ABAGAIL RD
Mailing Address - Street 2:
Mailing Address - City:JURUPA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92509-3337
Mailing Address - Country:US
Mailing Address - Phone:909-243-3666
Mailing Address - Fax:
Practice Address - Street 1:7801 ABAGAIL RD
Practice Address - Street 2:
Practice Address - City:JURUPA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92509-3337
Practice Address - Country:US
Practice Address - Phone:909-243-3666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-12
Last Update Date:2021-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2051OtherAMERICAN LOGISTIC COMPANY