Provider Demographics
NPI:1942361878
Name:SIDE TRAX EMS INC
Entity Type:Organization
Organization Name:SIDE TRAX EMS INC
Other - Org Name:SIDE TRAX EMS, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:R.N./C.F.O./DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-624-0863
Mailing Address - Street 1:PO BOX 269110
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-9110
Mailing Address - Country:US
Mailing Address - Phone:916-669-4613
Mailing Address - Fax:916-471-5139
Practice Address - Street 1:1429 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2651
Practice Address - Country:US
Practice Address - Phone:530-624-0863
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport