Provider Demographics
NPI:1770908113
Name:SPRINTER SERVICES
Entity type:Organization
Organization Name:SPRINTER SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:PIENAAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-709-7889
Mailing Address - Street 1:251 W IDAHO AVE # 55
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OR
Mailing Address - Zip Code:97914-2433
Mailing Address - Country:US
Mailing Address - Phone:541-709-0411
Mailing Address - Fax:541-889-6661
Practice Address - Street 1:489 SW 11TH ST
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OR
Practice Address - Zip Code:97914-3306
Practice Address - Country:US
Practice Address - Phone:541-709-0411
Practice Address - Fax:541-889-6661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-21
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID88783416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500604070Medicaid
ID808270600Medicaid