Provider Demographics
NPI:1457828824
Name:MERAKI TRANSPORT
Entity Type:Organization
Organization Name:MERAKI TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FELECIA
Authorized Official - Middle Name:N
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-916-2520
Mailing Address - Street 1:305 ENTERPRISE AVE
Mailing Address - Street 2:
Mailing Address - City:MERLIN
Mailing Address - State:OR
Mailing Address - Zip Code:97532-9802
Mailing Address - Country:US
Mailing Address - Phone:541-916-2520
Mailing Address - Fax:541-916-8363
Practice Address - Street 1:305 ENTERPRISE AVE
Practice Address - Street 2:
Practice Address - City:MERLIN
Practice Address - State:OR
Practice Address - Zip Code:97532-9802
Practice Address - Country:US
Practice Address - Phone:541-916-2520
Practice Address - Fax:541-916-8363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)