Provider Demographics
NPI:1467820019
Name:SAN JOAQUIN COUNTY BHS
Entity Type:Organization
Organization Name:SAN JOAQUIN COUNTY BHS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEER PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALMASTRO
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:DENNY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:209-468-2337
Mailing Address - Street 1:1149 N. EL DORADO ST.
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95205
Mailing Address - Country:US
Mailing Address - Phone:209-468-2337
Mailing Address - Fax:
Practice Address - Street 1:1149 N. EL DORADO ST.
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95205
Practice Address - Country:US
Practice Address - Phone:209-468-2337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-11
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)