Provider Demographics
NPI:1356906879
Name:SAN ANTONIO MEDICAL TRANSPORT INC.
Entity type:Organization
Organization Name:SAN ANTONIO MEDICAL TRANSPORT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RETO
Authorized Official - Middle Name:
Authorized Official - Last Name:WENK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-721-1487
Mailing Address - Street 1:870 N MOUNTAIN AVE # 202
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4161
Mailing Address - Country:US
Mailing Address - Phone:888-880-7268
Mailing Address - Fax:
Practice Address - Street 1:870 N MOUNTAIN AVE # 202
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4161
Practice Address - Country:US
Practice Address - Phone:888-880-7268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-09
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)