Provider Demographics
NPI:1265528855
Name:DELTA TRANSPORT SERVICES, INC.
Entity type:Organization
Organization Name:DELTA TRANSPORT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLAUDETTE AILEEN
Authorized Official - Middle Name:BRIONES
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:209-473-8606
Mailing Address - Street 1:3069 ENGLISH OAK CIR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95209-3922
Mailing Address - Country:US
Mailing Address - Phone:209-473-8606
Mailing Address - Fax:209-473-8606
Practice Address - Street 1:3069 ENGLISH OAK CIR
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95209-3922
Practice Address - Country:US
Practice Address - Phone:209-473-8606
Practice Address - Fax:209-473-8606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTN01204FMedicaid