Provider Demographics
NPI:1417411299
Name:ARMS REACH TRANSPORTATION LLC
Entity Type:Organization
Organization Name:ARMS REACH TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:EBONY
Authorized Official - Middle Name:DESHAWN
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:951-387-2811
Mailing Address - Street 1:320 N E ST STE 302B
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92401-1533
Mailing Address - Country:US
Mailing Address - Phone:760-251-4444
Mailing Address - Fax:562-206-7662
Practice Address - Street 1:16377 LAKESHORE DR UNIT 1B
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-5002
Practice Address - Country:US
Practice Address - Phone:951-387-2811
Practice Address - Fax:951-245-4908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-26
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA833125755Medicaid