Provider Demographics
NPI:1710572987
Name:WELLNESS FIRST TRANSPORTATION
Entity Type:Organization
Organization Name:WELLNESS FIRST TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:D
Authorized Official - Last Name:JARERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-650-9133
Mailing Address - Street 1:PO BOX 581133
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95358-0020
Mailing Address - Country:US
Mailing Address - Phone:209-650-9133
Mailing Address - Fax:
Practice Address - Street 1:745 OAKWOOD CT
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:CA
Practice Address - Zip Code:95334-9581
Practice Address - Country:US
Practice Address - Phone:209-650-9133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)