Provider Demographics
NPI:1720482433
Name:ROGUE VALLEY TRANSPORTATION DISTRICT
Entity Type:Organization
Organization Name:ROGUE VALLEY TRANSPORTATION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-608-2413
Mailing Address - Street 1:3200 CRATER LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-9075
Mailing Address - Country:US
Mailing Address - Phone:541-779-5821
Mailing Address - Fax:541-773-2877
Practice Address - Street 1:239 E BARNETT RD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-7927
Practice Address - Country:US
Practice Address - Phone:541-842-2072
Practice Address - Fax:541-842-2071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-09
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR230480347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR230480Medicaid