Provider Demographics
NPI:1679803365
Name:EMPOWERMENT NON EMERGENCY MEDICAL TRANSPORTATION INC.
Entity Type:Organization
Organization Name:EMPOWERMENT NON EMERGENCY MEDICAL TRANSPORTATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:MALONE SHORTER
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:574-226-3909
Mailing Address - Street 1:855 E MISHAWAKA RD LOT 107
Mailing Address - Street 2:855 E MISHWAKA LOT 107
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46517-4100
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:855 E MISHAWAKA RD LOT 107
Practice Address - Street 2:855 E MISHWAKA LOT 107
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46517-4100
Practice Address - Country:US
Practice Address - Phone:574-343-7892
Practice Address - Fax:574-343-2328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-04
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)