Provider Demographics
NPI:1134300536
Name:GREENLIGHT MEDICAL TRANSPORT INC.
Entity type:Organization
Organization Name:GREENLIGHT MEDICAL TRANSPORT INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-755-7115
Mailing Address - Street 1:939 UNION ST
Mailing Address - Street 2:
Mailing Address - City:CHERRY VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92223-4071
Mailing Address - Country:US
Mailing Address - Phone:951-755-7115
Mailing Address - Fax:951-755-7105
Practice Address - Street 1:939 UNION ST
Practice Address - Street 2:
Practice Address - City:CHERRY VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92223-4071
Practice Address - Country:US
Practice Address - Phone:951-755-7115
Practice Address - Fax:951-755-7105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)