Provider Demographics
NPI:1336517986
Name:APPLEGATE MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:APPLEGATE MEDICAL TRANSPORTATION LLC
Other - Org Name:APPLEGATE TRANSPORT
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:D
Authorized Official - Last Name:RAY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:832-848-2182
Mailing Address - Street 1:25502 TERRAIN PARK DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-8953
Mailing Address - Country:US
Mailing Address - Phone:832-848-2182
Mailing Address - Fax:
Practice Address - Street 1:25502 TERRAIN PARK DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-8953
Practice Address - Country:US
Practice Address - Phone:832-848-2182
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-11
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)