Provider Demographics
NPI:1013550276
Name:RENO MEDICAL TRANSPORT, LLC
Entity Type:Organization
Organization Name:RENO MEDICAL TRANSPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:II
Authorized Official - Credentials:RN, CCM
Authorized Official - Phone:702-979-9696
Mailing Address - Street 1:3645 W OQUENDO RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-3144
Mailing Address - Country:US
Mailing Address - Phone:702-979-9696
Mailing Address - Fax:702-979-9292
Practice Address - Street 1:3645 W OQUENDO RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-3144
Practice Address - Country:US
Practice Address - Phone:702-979-9696
Practice Address - Fax:702-979-9292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)