Provider Demographics
NPI:1861660045
Name:LR MEDICAL TRANSPORT, INC.
Entity Type:Organization
Organization Name:LR MEDICAL TRANSPORT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MYRNA
Authorized Official - Middle Name:RONATO
Authorized Official - Last Name:LIPATA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-601-6472
Mailing Address - Street 1:27313 HONEY SCENTED RD
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92555-4752
Mailing Address - Country:US
Mailing Address - Phone:951-601-6472
Mailing Address - Fax:951-601-6485
Practice Address - Street 1:27313 HONEY SCENTED RD
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92555-4752
Practice Address - Country:US
Practice Address - Phone:951-601-6472
Practice Address - Fax:951-601-6485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2844084343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)