Provider Demographics
NPI:1972831329
Name:JS MEDICAL TRANSPORT
Entity Type:Organization
Organization Name:JS MEDICAL TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JESSIE
Authorized Official - Middle Name:FRANCISCO
Authorized Official - Last Name:ARTAGAME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-654-1549
Mailing Address - Street 1:500 HAZELDELL AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JACINTO
Mailing Address - State:CA
Mailing Address - Zip Code:92582-5205
Mailing Address - Country:US
Mailing Address - Phone:951-654-1549
Mailing Address - Fax:951-654-1306
Practice Address - Street 1:500 HAZELDELL AVE
Practice Address - Street 2:
Practice Address - City:SAN JACINTO
Practice Address - State:CA
Practice Address - Zip Code:92582-5205
Practice Address - Country:US
Practice Address - Phone:951-654-1549
Practice Address - Fax:951-654-1306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-23
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)