Provider Demographics
NPI:1558750083
Name:1ST MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:1ST MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWMER
Authorized Official - Prefix:MS
Authorized Official - First Name:ERICKA
Authorized Official - Middle Name:ELIZABETH MICHELLE
Authorized Official - Last Name:HARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-595-3501
Mailing Address - Street 1:3511 DEL PASO RD
Mailing Address - Street 2:STE 160 POB418
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95835-2802
Mailing Address - Country:US
Mailing Address - Phone:916-595-3501
Mailing Address - Fax:
Practice Address - Street 1:7946 BELLINGRATH DR
Practice Address - Street 2:
Practice Address - City:ELVERTA
Practice Address - State:CA
Practice Address - Zip Code:95626-9726
Practice Address - Country:US
Practice Address - Phone:916-595-3501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-21
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)