Organization
SUPREME MEDICAL TRANSPORTATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARMELITA Q AVELLANO (MEMBER)
(909) 907-1031
Entity
Organization
Contact information
Practice address
9589 FOOTHILL BLVD, RANCHO CUCAMONGA, CA 91730-3506
(909) 466-7711
Mailing address
9589 FOOTHILL BLVD, RANCHO CUCAMONGA, CA 91730-3506
(909) 466-7711
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
01/08/2008
Last updated
11/05/2011
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