Provider Demographics
NPI:1376947820
Name:AFFORDABLE MEDFICAL TRANSPORTATION SERVICES, INC.
Entity Type:Organization
Organization Name:AFFORDABLE MEDFICAL TRANSPORTATION SERVICES, INC.
Other - Org Name:ADA VANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SHALE
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-234-5739
Mailing Address - Street 1:PO BOX 185
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90267-0185
Mailing Address - Country:US
Mailing Address - Phone:844-232-8267
Mailing Address - Fax:818-748-6269
Practice Address - Street 1:1350 JEFFERSON ST.
Practice Address - Street 2:OFFICE, ATTN, : ADA VANS
Practice Address - City:BARABOO
Practice Address - State:WI
Practice Address - Zip Code:53913
Practice Address - Country:US
Practice Address - Phone:844-232-8267
Practice Address - Fax:818-748-6269
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AFFORDABLE MEDFICAL TRANSPORTATION SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-13
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)