Provider Demographics
NPI:1295362861
Name:RESTORATION MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:RESTORATION MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAMAR
Authorized Official - Middle Name:T
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:NMD
Authorized Official - Phone:845-232-5093
Mailing Address - Street 1:4 JEFFERSON PLZ
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-4035
Mailing Address - Country:US
Mailing Address - Phone:845-232-5093
Mailing Address - Fax:
Practice Address - Street 1:4 JEFFERSON PLZ
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-4035
Practice Address - Country:US
Practice Address - Phone:845-300-2987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-24
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care