Provider Demographics
NPI:1750149704
Name:SUAVE MEDICAL TRANSPORT, LLC.
Entity type:Organization
Organization Name:SUAVE MEDICAL TRANSPORT, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:971-304-8347
Mailing Address - Street 1:84740 PAVONE WAY
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92203-2957
Mailing Address - Country:US
Mailing Address - Phone:971-304-8347
Mailing Address - Fax:
Practice Address - Street 1:84740 PAVONE WAY
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92203-2957
Practice Address - Country:US
Practice Address - Phone:971-304-8347
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)