Provider Demographics
NPI:1780414409
Name:SAFECARE MEDICAL TRANSPORT
Entity type:Organization
Organization Name:SAFECARE MEDICAL TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LIDSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:562-242-8081
Mailing Address - Street 1:4067 WINDOW ROCK RD
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86406-4526
Mailing Address - Country:US
Mailing Address - Phone:562-242-8081
Mailing Address - Fax:
Practice Address - Street 1:4067 WINDOW ROCK RD
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86406-4526
Practice Address - Country:US
Practice Address - Phone:928-706-8676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)