Provider Demographics
NPI:1437595030
Name:MEDICO TRANSPORT SYSTEM
Entity Type:Organization
Organization Name:MEDICO TRANSPORT SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:A/R MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBYNN
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:LONGENBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:928-242-1411
Mailing Address - Street 1:PO BOX 25
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-0025
Mailing Address - Country:US
Mailing Address - Phone:928-242-1411
Mailing Address - Fax:888-762-9665
Practice Address - Street 1:7365 S 4570 W
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84084
Practice Address - Country:US
Practice Address - Phone:928-242-1411
Practice Address - Fax:888-762-9665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport