Provider Demographics
NPI:1518410042
Name:HTM ENTERPRISES, INC
Entity Type:Organization
Organization Name:HTM ENTERPRISES, INC
Other - Org Name:HTM MEDTRANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:TICHENOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-321-8520
Mailing Address - Street 1:2617 PINEBLUFF DR
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-2909
Mailing Address - Country:US
Mailing Address - Phone:607-321-8520
Mailing Address - Fax:607-348-1671
Practice Address - Street 1:420 OLD MILL RD
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-3519
Practice Address - Country:US
Practice Address - Phone:607-321-8520
Practice Address - Fax:607-348-1671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY39607343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04435750Medicaid